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When it comes to managing hot flashes, here's what might work and what might waste your time—or money.

Waiting for you hot flashes to subside? These sweaty sessions can stay in your life for up to a decade or longer. There is relief, but not all remedies are equally effective.

"There are lots of muddied ideas out there, and you have to be careful," says Dr. Jennifer Pearlman, a women's health and wellness physician in Toronto. "Women are best served by a medical expert who can direct them to the most suitable options for them regarding safety and effectiveness."

Here's what might work and what might waste your time—or money.

1. Hormone therapy

Because hot flashes are triggered by falling estrogen levels, taking estrogen is the most effective way to alleviate them. Pearlman often recommends a combination of bioidentical estradiol (a type of estrogen) patch and progesterone taken as a capsule (for preventive health benefits). Prescribed hormones are produced in a lab using plant sources and pregnant mares' urine. Bioidentical hormones, synthesized from yams or soy, are identical on a molecular level to those your own body would make. Speak with your health-care professional about the right dose, and use with other approaches instead of relying solely on hormone therapy.

"To flood a woman with estrogen to solve a myriad of menopause-related problems is never going to be as safe as taking a more integrative approach," Pearlman says.

That may especially apply if you have certain health risks like blood clots or cancers associated with estrogen including breast and uterine.

2. Herbal supplements

Although the evidence isn't overwhelming, some botanical products—black cohosh, red clover, rhubarb extract—may take the edge off your hot flashes. Other menopause supplements you'll find on health-store shelves, including dong quai, kava and evening primrose oil, don't appear to make a difference. Supplements can have side effects—black cohosh can cause liver problems—so chat with your health-care provider first.

3. Non-hormone drugs

Gabapentin, a prescription drug for neurological disorders, lessens hot flashes in some women. "Gabapentin is sedating so, for my sleepless patients, I might get them to try it at night," says Pearlman. The blood pressure drug clonidine may help, and many antidepressants appear to relieve hot flashes as well. Again, these medications can have unwanted side effects.

4. Soy

Is it effective or only soy-soy? (We couldn't resist.) Research is limited and mixed. Soy contains plant estrogens, and Asian women who eat it regularly often experience fewer hot flashes. But most scientific studies have not found strong evidence for taking soy. A 2012 research review concluded that two daily servings may make a small difference. Worried soy can cause breast cancer? When eaten in moderate amounts (two daily servings), it won't. Soy compounds may in fact play a protective role against cancer.

5. Hypnosis

Research is promising, especially since a 2013 randomized controlled trial showed that hypnotic relaxation therapy improved hot flashes by up to 80 per cent. The women in the study also learned self-hypnosis. One of the keys: cool imagery, such as a snowy scene.

Next: Avoiding caffeine and alcohol

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