What kind of hot flasher are you?

The hot flash — that sudden feeling of warmth that can leave a woman flushed and drenched in sweat — has long been considered the defining symptom of menopause. But new research shows that the timing and duration of hot flashes can vary significantly from woman to woman, and that women appear to fall evenly into four hot-flash categories.

Some women, called “early onset” hot flashers, begin to experience hot flashes long before menopause. Symptoms can begin five to 10 years before a woman’s last period, but the symptoms stop around the time of the final menstrual cycle.

Then there are women who don’t experience their first hot flash until after their final menstrual period, the “late onset” hot flasher. And some women fall into a group the researchers called the “lucky few.” Some of these women never experience a single hot flash, whereas others briefly suffer only a few flashes near the end of the menopausal transition.

And then there are the “super flashers.” This unlucky group includes one in four midlife women. The super flasher begins to experience hot flashes relatively early in life, similar to the early onset group. But her symptoms continue well past menopause, like those in the late onset group. Her symptoms can last 15 years or more.

Reversal of severe brain fog in a 59 year old woman who’s ambition was to climb a mountain.


The most well known symptoms in menopause are hot flushes and night sweats, but the most common are fatigue, anxiety, brain fog and weight gain.

In women following an inappropriate diet, oestrogen declining leads to a severe energy deficiency in the brain and body, leading to ALL these symptoms.

I have developed a protocol that can reverse this energy deficit – and reduce symptoms by 75% – with nutrition alone in 8 weeks.


LM was 59 years old when she came to see me asking for help with severe menopausal symptoms. Her most significant concerns were severe brain fog, low energy and wanting to get fit to do a trek.

She said:

“I have always had a busy, active life and enjoyed walking and cycling holidays. Now when I have an active day at work I get home exhausted and sleep most of the evening. I find I have a ‘fog’ in my brain which makes it difficult to work especially as I have several ongoing responsibilities at any one time. This year I am transitioning to retirement and I want my energy back in order to enjoy it.”

LM had gone up a dress size in the last year and although she had cut down on eating biscuits and cakes, this didn’t make any difference to her weight. She was still having some hot flushes and night sweats. She regularly fell asleep straight after dinner and was tired in the daytime. She wanted to do regular exercise to prepare for the trek that she planning, but she just didn’t have the energy to do it. 

Health history

  • LM had been on the pill for 20 years 
  • Peri-menopause started when she was about 50 and she had her last period at 53 
  • She started noticing menopausal symptoms around 4 years previously

Nutrition history

  • LM’s diet was high in sugar and carbohydrates: typically cereal with fruit, or porridge with sugar for breakfast, bread and soup for lunch, and frequent rice or pasta dishes for dinner. 
  • She always had a desert such as cake or ice cream or biscuits after lunch and dinner. 
  • She frequently snacked on fruit, dried fruit or biscuits. 
  • She drank little water and 5-7 cups of tea with milk every day

Menopause type analysis

  • 64% of symptoms were associated with oestrogen metabolism 
  • Progesterone was fine 
  • Testosterone was possibly low

Significant test results

Vitamin DSevere deficiencyLow immune function, skeletal concerns
Liver enzymesHighImpaired liver function

Root cause analysis

During the menopausal transition and post-menopause, a woman’s body is switching from using sugar as an energy source, to using fat. Hence menopausal symptoms are not really an oestrogen deficiency problem, they are an energy deficiency problem. 

LM’s diet was too high in sugar for this phase in her life. Her body was converting her dietary carbohydrates to fat, and at the same time it she was not able to burn fat for energy. This meant that her brain and body were starving for energy, leading to severe brain fog, weight gain, hot flushes, night sweats and feelings of severe exhaustion. 

Her high sugar intake was affecting her liver, possibly leading to a fatty liver, and at the same time her vitamin D deficiency was lowering her brain function and preventing restful sleep.



  • I recommended MenoKeto, a nutrition formula that I have developed through my clinical practice that is ideal for women in peri-menopause and menopause;
  • LM was provided with a range of suitable recipes and meal plan suggestions. 
  • LM was asked to follow my 7 food rules as closely as possible. 


  • Vitamin D: calibrated dose of emulsified vitamin D drops



  • 0 – none
  • 1 – mild
  • 2 – moderate
  • 3 – severe
SymptomsWeek 1
Hot flushes2
Night sweats2
Vaginal dryness2
Pain with intercourse2
Poor memory2
Foggy thinking3
Mood swings1
Sleep disturbance2
Hair loss1
Weight gain2
Decreased sexual desire2
Decreased sexual arousal2
Decreased sexual response2
Total score34

Results: follow-up 2 (+8 weeks)

  • LM reported that she was feeling much better and the brain fog had completely lifted. She was able to multi-task with ease, and she happily started and finished writing work proposals on time and with pleasure. 
  • Her energy was back and she had started going to pilates classes, as well aiming to go swimming 2-3 times a week, and starting Tai Chi. 
  • She found the nutrition recommendations easy to follow and had upgraded her meals. 
  • She was now only eating 2-3 meals a day without any cravings or energy dips in the daytime. 
  • LM’s nutrition and supplements were further adjusted for the next 3 months to ensure complete remission of symptoms.



  • 0 – none
  • 1 – mild
  • 2 – moderate
  • 3 – severe
SymptomsWeek 1Week 8
Hot flushes20
Night sweats20
Vaginal dryness21
Pain with intercourse20
Poor memory20
Foggy thinking30
Mood swings10
Sleep disturbance20
Hair loss10
Weight gain20
Decreased sexual desire21
Decreased sexual arousal21
Decreased sexual response21
Total score346
Symptoms reduced by 82%

My specialist menopause plan concentrated on my nutrition and had supplements personalised to me to support me – it has seen my whole health and mindset change.


My review

I was delighted for LM, she cognitive function was excellent and she had more than enough energy in day, enough to start training for her mountain trek.

No woman should be suffering through menopause and the main change that needs to made is nutrition.

Postmenopausal women can fight off hot flashes and night sweats by pumping iron, a new clinical trial shows.

“Resistance training is already recommended for all women always, but now we can see it may be effective also for hot flashes around menopause,” Dr. Emilia Berin of Linkoping University in Sweden, who led the study, told Reuters Health.

Hot flashes, undoubtedly the most common symptom of menopause, are not just uncomfortable and inconvenient, but numerous studies demonstrate they may increase the risk of serious health problems, including heart disease. A new study suggests that hot flashes (especially when accompanied by night sweats) also may increase the risk of developing diabetes.

As reported in “Vasomotor symptom characteristics: are they risk factors for incident diabetes?” data was analyzed from the more than 150,000 postmenopausal women who participated in the Women’s Health Initiative (WHI) to confirm that the occurrence of hot flashes was associated with an elevated diabetes risk. Of the total population studied, 33% of the women had experienced hot flashes. Any incidence of hot flashes was associated with an 18% increased diabetes risk, and this risk continued to climb on the basis of the severity and duration of the hot flashes. Moreover, diabetes risk was the most pronounced for women reporting any type of night sweats but only if the onset of hot flashes occurred late in the menopause transition.

Diabetes is a serious health risk currently affecting 15% of women aged 55 years and older. Its incidence is expected to more than double by 2050. Compared with men with diabetes, women with diabetes have a higher risk of being hospitalized for or dying from diabetes and its complications, which makes the timely identification and management of diabetes through lifestyle intervention or medical management critical.

This study showed that, after adjustment for obesity and race, women with more severe night sweats, with or without hot flashes, still had a higher risk of diabetes,” says Dr. JoAnn Pinkerton, NAMS executive director. “Menopause is a perfect time to encourage behaviour changes that reduce menopause symptoms, as well as the risk of diabetes and heart disease. Suggestions include getting regular exercise and adequate sleep, avoiding excess alcohol, stopping smoking, and eating a heart-healthy diet. For symptomatic women, hormone therapy started near menopause improves menopause symptoms and reduces the risk of diabetes.”

A new study of more than 2,000 perimenopausal and menopausal women showed that moderate-severe vasomotor symptoms (hot flashes or night sweats) were an independent and significant risk factor for moderate-severe depression. Researchers explored the controversial link between hot flashes and depressive symptoms by focusing on more severe forms of both conditions and concluding that there is likely a common underlying cause, as reported in an article published in Journal of Women’s Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Women’s Health website until May 18, 2017.

Data presented in the article entitled “Moderate-Severe Vasomotor Symptoms Are Associated with Moderate-Severe Depressive Symptoms,” demonstrate that among a group of women ages 40-65, those with moderate-severe hot flashes were significantly more likely to have moderate-severe depression than women with no or mild vasomotor symptoms. Roisin Worsley, MBBS, Robin Bell, PhD, Pragya Gartoulla, Penelope Robinson, and Susan Davis, MBBS, Monash University, Melbourne, Australia, found hot flashes, depressive symptoms, and use of antidepressant medication to be common in the age range of women included in the study. The researchers also examined whether or not moderate-severe depression was associated with a greater likelihood of psychotropic medication use, smoking, or binge drinking at least once a week.

The therapeutic benefits of omega-3 fatty acids – which are abundant in certain fish oils – have long been known. In the 1950s, upon the discovery that omega-3 improves brain development, cod liver oil was given for free to young children, pregnant women, and nursing mothers. In the 80s, scientists reported that eskimos enjoy better coronary health than their mainland counterparts as a result of their fish rich diets. And in 2009, a study published in the Menopause journal suggested that omega-3 helps reduce the frequency of hot flushes in menopausal women.

 As you can see, the hype that surround omega-3 is warranted, and not something to be shied away from.

 The Truth About Fats

Many women are concerned about fat, and wrongly believe that consuming fat will make them overweight. The truth is, however, that an extremely low-fat diet won’t regulate your weight – and it certainly won’t enhance your health. Fat can be hugely beneficial in the right form, and by consuming fatty acids such as omega-3, you will surely be more healthy.

Research has confirmed that omega-3 fatty acids may have an excellent effect on impacting degenerative diseases, such as heart disease, rheumatoid arthritis, hypertension, Alzheimer’s disease, diabetes, and many more. As for menopause, omega-3 fatty acids contain anti-inflammatory properties shown to have a positive effect on many of the symptoms associated with “the change”.

What can omega-3 help with?

Because of its wonderful properties, omega-3 can greatly help women during menopause. It helps treat a range of menopausal symptoms, such as:

  • Hypertriglyceridemia– Postmenopausal women may have higher triglyceride concentrations than premenopausal women, exposing them to increased risk of coronary heart disease. As  omega-3 offers a triglyceride-lowering effect, many practitioners recommend menopausal women obtain a bare minimum 1g/day as provided by your diet or supplementation.
  • Joint pain/menopause arthritis– Omega-3 fats can reduce inflammation, which may help relieve joint pain and stiffness related to menopause arthritis. Omega-3s work in a similar way as non-steroidal anti-inflammatory drugs (NSAIDs).
  • Menstrual pain – As part of your ovaries’ frustrating grand finale, perimenopausal women often experience strong menstrual pain and cramping. This pain is often caused by substances called prostaglandins, which come in both “good” and “bad” form. Menopause promotes the bad kind, while  omega-3 fatty acids promote the good kind.
  • Depression– Women are twice as likely to suffer depression compared with men, and the risk is even greater following menopause. Irritability and sadness are common emotional symptoms of menopause, but omega-3 may effectively alleviate these symptoms. Omega-3s work to improve mood and restore structural integrity to brain cells that are critical in performing cognitive functions.
  • Osteoporosis– An increased intake of omega-3 acids increases bone mineral content and produces healthier, stronger bones. As menopause can increase a woman’s risk of developing osteoporosis due to a drop in oestrogen levels, omega-3 fatty acids should be an essential part of a menopausal diet.
  • Hot flushes– The frequency of hot flushes in women going through menopause can vary from as little as once a week to every 30 minutes. Some hot flushes last minutes, while others a mere few seconds. Studies have shown that while omega-3 may not affect the intensity of hot flushes, it can halve the frequency of hot flushes with the right dosage.
  • Vaginal dryness– Fatty acids help to lubricate the body in general, therefore helping with dryness of the vagina – a common symptom of menopause.

Overweight women who experience hot flashes—the uncomfortable flushing and sweating spells that accompany menopause—may be able to cool those symptoms by losing weight, a new study suggests.

“If you’re a woman who is overweight or obese, you can substantially improve your hot flashes by losing weight through diet and exercise,” says Alison Huang, MD, the lead author of the study and a professor of internal medicine at the University of California, San Francisco.

“Weight loss isn’t just something that will benefit your long-term health 10, 20, or 30 years from now,” she adds. “It can make a real difference in your symptoms and quality of life right now.”

Previous research has shown that women with higher body-mass indexes (BMI) tend to experience worse hot flashes. Until now, however, few studies have tried to measure the immediate effect that weight loss has on symptoms.

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