More than 70 percent of perimenopausal  and postmenopausal women have hot flashes, which can cause excessive sweating, flushing and chills. A recent pilot study found that weight loss may tame the flames: Seventeen obese and overweight women who participated in a diet and exercise program cut their daily number of hot flashes in half compared to a control group of 16 women who did not participate and saw little change.

After six months, the women in the intervention group reported 63 fewer hot flashes over a two-week period—a reduction of 4.5 per day. “The women in the weight-loss group reduced their hot flashes significantly, but they also lost about 20 pounds over six months and reduced their body fat, which offers additional potential health benefits,” says Dr. Denise Black, an obstetrician-gynecologist in Winnipeg and a member of the SIGMA Canadian Menopause Society.

While larger studies are needed to assess the impact of weight loss on hot flash reduction, women in the weight-loss group shed more than 10 percent of their body weight and five percent of their body fat, reductions that have been associated with significant improvements in insulin sensitivity, lipids and blood pressure.

Speak up to improve your sex life
Many perimenopausal and postmenopausal women think vaginal dryness, reduced desire and pain during sex are symptoms that can’t be treated. A recent study found that more than six in 10 postmenopausal Canadian women admit they avoid sexual intimacy due to vaginal atrophy symptoms, yet only 20 to 25 percent seek help. “For women who suffer from vaginal atrophy, replacement with sufficient local estrogen is unquestionably the most effective treatment and a major factor contributing to good sexual health and a healthy, enjoyable sex life,” says Dr. Christine Derzko, associate professor of obstetrics, gynecology and internal medicine at the University of Toronto, and board member and vice-president of the SIGMA Canadian Menopause Society.

Women can suffer stabbing pain, burning or chafing and may need to urinate more often as a result of the condition. In the absence of estrogen, vaginal tissue can regress, become thinner and more easily irritated, making intercourse painful. “A vagina on estrogen is like a pleated skirt: extensible and easy to move around. Vaginal atrophy is like a pencil skirt: narrow, nonextensible and irritating,” explains Dr. Black.

An estrogen treatment inserted vaginally delivers a small amount of hormone to help restore tissue thickness and lubrication, and is a safe and effective option for almost all women, says Dr. Black. “Women who are reluctant to take oral hormones are surprised to find out that a full year of treatment with vaginal estrogen is equivalent to a single daily dose of oral estrogen,” she says. “Women with breast cancer who are undergoing therapy with an aromatase inhibitor should see a menopause specialist for a consultation if vaginal estrogen is considered.”

What’s the latest position on oral hormones? “For women between 50 and 60, there are only a few risks associated with taking systemic menopausal hormone therapy, but there are lots of benefits,” says Dr. Derzko. “If you are prescribed hormones, you should take them. But women need to take charge of their health in a global sense, not just swallow a pill and do nothing more. They also need to exercise, watch their diets, not smoke, and limit their alcohol intake.”

Are you experiencing hot flashes? Our nutritionist reveals how to get through menopause naturally.

This content is vetted by medical experts

This story was originally titled "Managing Menopause" in the November 2014 issue. Subscribe to Canadian Living today and never miss an issue!