Treatment of Hot Flashes With Chinese Herbal Medicine

Updated November 2026

Hot flashes occur when estrogen is lowered. It is a sign of peri-menopause. Many people do not realize that hot flashes can occur even when perimenopause is not taking place.

A Case Study: Hot Flashes at 35

I recently had a patient who was suffering from hot flashes at 35 years old. She also was having delayed menstruation. Her hormone panel showed the she had high FSH and told her she was going through early stages of peri-menopause.

He prescribed her Hormone Replacement Therapy in order for her to menstruate and reduce the hot flashes she was experiencing. He wanted to keep up her estrogen levels so that she would not suffer from bone loss which can lower when estrogen lowers. She reluctantly went on HRT therapy but was concerned about her overall health.

When Louisa (name changed due to patient anonymity) came to see me, she was on HRT therapy for two years. She expressed her concerns of being on it for the rest of her life and wanted a more natural way to deal with her hot flashes.

Hot Flashes in Chinese Medicine: When Yin Runs Low

In Traditional Chinese Medicine, hot flashes normally occur because of an insufficiency of fluids called “yin”. Yin fluids cool our body. When our body is balanced and homeostasis is at an equilibrium, we should not feel hot nor cold.

When yin fluids are insufficient or depleted, the cooling unit is lowered; therefore, heat rises and hot flashes can occur. This can be very extreme and cause a lot of discomfort in women. Hormone replacement therapy is the main way to reduce hot flashes.

How Chinese Herbal Medicine Helped

Louisa and I discussed going off HRT and beginning Chinese herbal medicine. I explained to her that it would take some time to restore her hormones in order for menstruation to take place. Louisa went off HRT and began a blend of Chinese herbal medicine that was tailored specifically to her body.

As she went off HRT and began herbs, she only experience slight heat but no hot flashes. Her menstruation came back in three months and she no longer experienced being warm nor had any signs of hot flashes.

I gave her a list of dietary recommendations as well as recommended a reduction of stress and increased sleep which are critical to restoring fluids. She now menstruates on her own and does not experience hot flashes. I felt this was an important step in her overall health and reproductive health in a natural way.

Important: Every case is different. Never stop or change hormone replacement therapy on your own. If you would like to explore Chinese herbs, talk to your doctor and your acupuncturist together so the plan is safe for you.

Chinese Herbs Commonly Used for Hot Flashes

There is no single “hot flash herb.” A licensed practitioner chooses a formula for your pattern, then adjusts it as your symptoms change. Classical formulas often used as a starting point include:

• Liu Wei Di Huang Wan: a foundational formula to nourish yin when there is dryness, night sweats and a warm feeling in the palms and feet.
• Zhi Bai Di Huang Wan: a variation used when heat signs are stronger, such as intense flushes and restless sleep.
• Er Xian Tang: used when hot flashes come with tiredness, cold feet or low back weakness, a mix of yin and yang running low.

Herbs are prescribed after a full review of your health history and medications, and they are never a do-it-yourself treatment. You can read more about how we prescribe in our Chinese herbal medicine in NYC page.

Can Acupuncture Help Hot Flashes Too?

Yes. Acupuncture is often used alongside herbs to calm the nervous system, improve sleep and reduce how often and how strongly hot flashes come. Many women notice fewer night sweats and better sleep within a few weeks of weekly treatment.

Food and Daily Habits That Help

• Cut back on alcohol, coffee and very spicy food, which add heat.
• Eat cooling, moistening foods such as pears, cucumbers, leafy greens, black beans, tofu and black sesame.
• Protect your sleep: going to bed before 11 pm helps the body restore yin.
• Manage stress with gentle movement such as walking, yoga or tai chi.
• Dress in layers and keep a fan by the bed for night sweats.

Frequently Asked Questions

Can you get hot flashes before menopause?

Yes. Hot flashes can start in perimenopause, sometimes in the late 30s or early 40s, and can also come with other hormone changes, as in Louisa’s case.

How long do Chinese herbs take to help hot flashes?

Many women notice a change within a few weeks, but restoring a regular cycle, when that is part of the picture, usually takes about three months.

Can I take Chinese herbs with HRT?

Sometimes, but only with your doctor’s knowledge. Your practitioner will review your medications before prescribing anything.

Hot flashes are one of the concerns we support through women’s health acupuncture in NYC. When hot flashes come with a delayed or changing cycle, as in Louisa’s case, read about acupuncture for irregular periods and acupuncture for no periods.