Hot flashes—a review of the literature on alternative and complementary treatment approaches

Alternative Medicine Review, August, 2003 by Hazel A. Philp

The first placebo-controlled, randomized, crossover trial of vitamin E, in 105 breast cancer survivors who were experiencing an average of at least 2-3 hot flashes daily, showed a clinically small but statistically significant advantage for vitamin E (400 IU twice daily) for four weeks over placebo. (108) Vitamin E was successful, even for some women using tamoxifen, which has been shown to increase hot flashes. (109)

Vitamin E supplementation has also been shown to reduce other common symptoms of menopause, including fatigue, dizziness, palpitations, and nervousness. (105,107) Although there is scant published information demonstrating the effectiveness of higher doses of vitamin E for hot flashes and other menopausal symptoms, a daily intake of 400-1,200 IU has been observed by both conventional and CAM practitioners to be clinically beneficial.

Hesperidin and Vitamin C

Interest has increased in the possible health benefits of flavonoids owing to their potent antioxidant and free-radical scavenging activities observed in vitro. (110) Some flavonoids demonstrate a very weak estrogenic effect, which may be why regular use can alleviate symptoms associated with menopause. (111)

The flavonoid hesperidin, from citrus fruit, is known to improve vascular integrity and decrease capillary permeability. (112) A dietary deficiency has been linked to abnormal capillary leakiness, pain and weakness in the extremities, and nocturnal leg cramps. Both hesperidin and its aglycone hesperitin have been reported to possess a wide range of pharmacological properties. (113)

In one clinical study, 94 menopausal women with hot flashes were given a daily formula for one month containing 900 mg hesperidin, 300 mg hesperidin methyl chalcone, and 1,200 mg vitamin C. After one month, symptoms of hot flashes were completely relieved in 53 percent and reduced in 34 percent of the women. (114)

No signs of toxicity have been observed with the intake of hesperidin or related compounds.

Ferulic Acid (Gamma Oryzanol)

Ferulic acid is a ubiquitous plant constituent that arises from the metabolism of phenylalanine and tyrosine. (115) It is found in grains and isolated from rice bran oil, (112) occurs primarily in seeds and leaves, (115) and has potent antioxidant potential. (115) Ferulic acid has also been found in dong quai. (98)

Ferulic acid may protect against various inflammatory conditions due to its free-radical scavenging effects. (115)

In the early 1960s, ferulic acid was found to be effective for reducing menopausal symptoms, including hot flashes. (99) Ensuing studies have substantiated its effectiveness. (100) In one small study, eight menopausal women and 13 women who had their ovaries surgically removed were given 300 mg ferulic acid daily. At the end of the one-month trial 67 percent of the women had at least a 50-percent reduction in menopausal symptoms. (99)

In a later study, ferulic acid at a dose of 300 mg daily was also found effective, with 85 percent of 13 women reporting an improvement in menopausal symptoms. (100)