To keep hormonal health as balanced and symptom-free as possible, functional nutritionist Nicole Negron starts with the HPA (hypothalamic, pituitary, adrenal) Axis.

This axis is what regulates our stress response system, says Nicole; so if you’re lying in bed at night, unable to sleep because of bills, worries about kids or aging parents, etc., your HPA is responding to that stress.

Your brain (hypothalamus) sends stress signals to the pituitary, which in term triggers the adrenal gland to produce and release more cortisol into the bloodstream.

Cortisol, says Nicole, triggers an inflammatory immune response via inflammatory cytokines. These travel back up and talk to the brain, setting the cycle off again. And inflammation equals heat.

So what can trigger the inflammatory response that can lead to hot flashes?

Stress. This is probably the biggest trigger, Nicole says. Stress starts in the brain, firing off the cycle; it’s also the point where there’s the best opportunity for intervention, because our stressors are often things we have control over.

Controlling triggers in your life

We need to keep the body calm and satiated, Nicole says; this is how we start managing the signals that can set off the hot flash cycle.

Work. Are you where you want to be and doing what you want to be doing? Are you fulfilling your life’s passions and purpose? If not, can you change or find a way to redirect your current job to be closer to your goals?

Family. If you have aging parents or younger kids who need care, are you asking for help when you need it? Says Nicole, many women, including her clients, are wonderful at everything except two critical skills: asking for help, and saying no. Learn to do both of these to make life so much simpler and less stressful.

Partner. Are things good with your spouse or partner, if you have one? Are all your many loads – financial, physical, emotional – being divided equally, or are you taking on more than your share? Can you have a conversation or get therapy to make this relationship a source of strength and not more stress?

Before you turn to a medical intervention, be sure you’re maximizing what Nicole calls the “in-house remedies.” You know what stresses you out; it’s time to do the work to reduce those stressors in favor of reducing hot flashes and supporting long-term good health.

Nutrition and hot flashes, the “no’s”

“People hate me for saying this,” Nicole says, laughing, “but you have to get rid of alcohol, all sugars, and caffeine.”

“It’s about survival. Women wake up in the morning, they don’t have much energy even though they’ve been ‘resting’ for the last several hours. They’re short on time, they’re stressed. But if we’re talking about calming the HPA Axis, you can’t start your day with coffee. One, it’s dehydrating, and two, it’s activating your stress response. Wine is the same, so no wine at night! Alcohol, sugar, and definitely caffeine all can increase the frequency, duration, and intensity of hot flashes.”

Nutrition and hot flashes, the “yes”

Really the question should be, what buffers the stress response? Micronutrients are great, especially if you also have a thyroid condition to consider, says Nicole. Leafy greens are great; cooked if you have difficult digesting or absorbing the nutrients, raw if not. A digestive enzyme might also make the goodness more bio-available.

Selenium is great for supporting your system, so eat a couple of Brazil nuts every day. Many women report feeling better with an increase in foods containing vitamins D and E and Zinc, or adding ashwaganda to their diet.

Phytonutrients: if you have lower estrogen, estrogenic foods can be helpful. Soy foods like tofu, edamame; flax seeds, sweet potatoes – these may have a positive effect.

What else can we do to reduce hot flashes?

Gentle yoga before bed is great for those with night sweats, Nicole says. Think about breathing from the diaphragm, which soothes and calms. Qigong, a type of tai chi, done an hour or so before bed can be very calming to the central nervous system, making it easier to sleep deeply.

Turn off screens, reduce activity and do things that relax the body and mind. No answering emails, no watching TV that hypes up adrenaline. In the two hours before bed, you need to ready your mind and body for rest, so activity, food, and drink all need to support that goal.

If you follow a religious or spiritual practice, that can be very calming. Touch is very nourishing and healthy as well, particularly as we age, so getting a foot or shoulder massage from a loving partner as you discuss your day (the good, calm parts of your day, anyway) may actually reduce night sweats. For those who aren’t partnered, schedule regular massages. Your insurance might even cover it. Finally, as long as you’re not drained all day, every day, an orgasm before bed is great, says Nicole. “And you don’t need anyone else for that.”

Hot flashes can be disruptive to such a level that women even consider leaving their jobs or drastically reduce their social lives to avoid embarrassment. At Gennev we believe there should be no embarrassment around the body’s natural functions, but we understand society hasn’t quite caught up with this notion yet. We also believe women don’t need to suffer in silence – there are remedies that help. You may just have to keep experimenting with different options until you find the solution or combination of solutions that work for you.

Just please, always keep in touch with your doctor about any new lifestyle change, supplement, medication, or practice that could potentially interact with medications or conditions.

If lifestyle and/or nutritional choices have helped you with hot flashes, we'd love to hear what worked for you. Share in the comments below, join the conversation in our community forums, fill us in on Facebook or in Midlife & Menopause Solutions, our closed Facebook group.