Taming the hot flash dragon

A common reason women visit Red Clover Clinic is to find relief from hot flashes associated with perimenopause and menopause. These seemingly random flushes of heat, often accompanied by sweat, can be very disruptive to daily life and, especially, to sleep.

Despite the fact that scientists haven’t figured out exactly why hot flashes occur, it is clear that they are associated with shifting hormones, more specifically the drop in estrogen levels that occurs around menopause. The two treatment protocols that I find most effective when treating hot flashes are German auricular acupuncture and herbal medicine approaches. 

What causes hot flashes and how can they be treated naturally?

Understanding the basic physiology behind hot flashes is important when deciding how to treat this uncomfortable and frustrating condition.

In addition to shifting hormones, the hypothalamus region of the brain is also likely involved. The hypothalamus is the part of the brain that links the nervous system with the endocrine (hormonal) system. This linkage is often referred to as the hypothalamic-pituitary-gonadal axis. When one part of this relay system changes, the whole system is affected. Interestingly, the hypothalamus plays a major role in temperature regulation of the body. It is responsible for many other things, including regulating sleep cycles and food and water intake.

No two women’s treatments are exactly alike, but typically they are variations on acupuncture and herbal medicine. Sometimes I use both approaches.

I prefer to treat women weekly until the hot flash symptoms have become very controlled. Then we have to find an appropriate maintenance schedule based on the individual’s needs. The treatment schedule is quite variable from woman to woman.

German auricular acupuncture

The primary reason that I prefer to treat hormone-related conditions with German auricular acupuncture is because there are specific points that relate to each individual hormone. There are also points that work to balance hormones from both the Western and the Chinese medicine paradigms. It is very precise work with excellent outcomes. 

I devoted the newsletters in the second half of 2012 to describing German auricular acupuncture and how it works. Please look to these three newsletters for more in-depth information about this powerful medicine:  July/AugustSeptember/October November/December

When treating hot flashes with auricular acupuncture, I tend to treat three major types of points: the estrogen point, hypothalamus point, and kidney-related points . I only treat points that are signified as “active,” indicated by low electrical conductance. I also select other points to treat according to other symptoms or complaints. 

  • If the estrogen levels are very low and in need of support, the estrogen point is commonly active. The power of this point has become clear to me, because after a few treatments, treating this point occasionally backfires. An intense fluctuation caused by auricular acupuncture can cause a temporary increase in hot flash symptoms. My interpretation of this is that the brain has become almost over-sensitized to estrogen and its fluctuations.
  • Since the hypothalamus is a system regulator rather than a specific hormone, treating the hypothalamus point is almost always helpful. It up-regulates and down-regulates as needed. It also has an impact on sleep, which is often disturbed by hot flashes, so it is kind of a two-for-one point.
  • The kidney-related points enter into this protocol from a Chinese medicine perspective. As we age, it is normal for our kidney energy to become weaker and more deficient. And, most symptoms of menopause are associated with kidney deficiency. Therefore, supporting the kidneys is vital to successful treatment.  In German auricular acupuncture there are several points associated with the kidneys. The meridians are mapped on the ear, as they are on the body in other forms of acupuncture. I find three points on the kidney meridian to be effective in treating hot flashes, and they correlate with the body points: Kidney 1, Kidney 3, and Kidney 7. 

Herbal medicine  

There are many herbal approaches to treating hot flashes. What I have found to be most effective is creating a formula that isn’t limited to, but includes at least one or two of the following herbs, pictured below: 

  • White Sage (Salvia apiana)
  • Vitex, a.k.a. Chaste Berry (Agnus castus)
  • Black Cohosh (Cimicifuga racemosa)
  • Motherwort (Leonurus cardica) and 
  • Passionflower (Passiflora incarnata).

White Sage is almost always included, as it is astringent and helpful for general deficiency and sweating. Vitex and Black Cohosh are both powerful female hormone regulators. Motherwort is especially effective if the hot flashes that are accompanied by palpitations and anxiety. And Passionflower is calming and promotes sleep.

It has become common to think of Black Cohosh as the menopause herb; however many women say that it doesn’t work. In my opinion, it is important to select and combine herbs according to each individual person, not just the disease. Each person walks away with a combination of herbs in particular proportions unique to them. 

Furthermore, I find herbs to be most effective in their whole form. Oftentimes, when women have tried an herb like Black Cohosh, they have purchased a standardized extract, which is a pharmaceutical version of the herb. The specific constituent that is thought to be the active ingredient is separated and concentrated, as if it were a drug. Standardized extracts are more likely to cause side effects, and may not be assimilated by your body as well as a whole herb extract like a tincture or decoction.

If hot flashes are keeping you awake or affecting your quality of life, German auricular acupuncture, herbs, or a combination, may help. 

White Sage (Salvia apiana)

Vitex (Agnus castus)

Black Cohosh (Cimicifuga racemosa)

Motherwort (Leonurus cardica)

Passionflower (Passiflora incarnata)


“I’ve been struggling for many years with anxiety/depression and recently was suffering from symptoms of hormonal imbalance. My nights were often riddled with panic attacks and I had an overwhelming sense of irrational fear. I started having irregular periods, sometimes not getting them at all… and the periodic hot flashes started. 

I began to see Anita at Red Clover Clinic for acupuncture and herbal medicine, and was amazed at how quickly I responded to the treatments and herbs. My nights became wonderfully quiet, as my mind was still and free of panic. My hormones have become balanced and I don’t get those pesky hot flashes. Now I continue to see Anita a few times a month, on a health maintenance basis. I am so happy to have her as my practitioner. She is caring, knowledgeable, and dedicated to her practice. Her clinic is inviting, comfortable, and cozy. I would highly recommend Red Clover Clinic!” – S.J.