Menopause hit Amelia Cerbelli hard. Hot flashes ruined her mood, sleep, and outfits; she was sweaty, uncomfortable, and oh-so irritable (especially in the summer). The only thing that made her feel better was her silent rebellion in the workplace. Every morning when she arrived at the office, Cerbelli turned the thermostat way, way down, until she heard a click indicating it was at its lowest possible setting.
“Everyone was freezing and wearing sweaters,” recalls Cerbelli, 65, who lives in the Poconos in Pennsylvania and is now on the other side of her 12-year bout with menopause. “It was like a meat locker in there. They finally put some kind of lock on it so I couldn't change it.”
Not everyone experiences menopause-related hot flashes—but for those who do, record-breaking summer temperatures can turn the heat up on frequency and severity. That’s physically unpleasant, of course, but also mentally draining. “Hot flashes give one a sense of a loss of control, because they come on suddenly and unpredictably,” says Dr. Kathleen Jordan, chief medical officer of Midi Health, a virtual care clinic focused on navigating perimenopause and menopause. “People think it’s temporary—that you just have them for a year or two, and then it goes away, and they need to suffer through it or grin and bear it. But for a significant number of women, these go on for over a decade, and some in perpetuity. So we need to figure out how to deal with it.”
We asked a range of people—women who have or are currently going through menopause, as well as doctors—how to best cope with hot flashes in the summer heat.
Avoid caffeine, smoking, alcohol, and spicy foods
Dr. Kelli Burroughs, department chair of obstetrics and gynecology at Memorial Hermann Sugar Land Hospital in Houston, has noticed that patients’ anxiety about hot flashes spikes with the temperature. They tell her that when one strikes, it feels like “a wave of heat has overtaken their entire body,” she says, followed by sweating and then chills that last anywhere from 10 seconds to 10 minutes.
Read More: Menopause Is Finally Going Mainstream
Burroughs advises patients to avoid caffeine, even in the morning: “I hate making that recommendation, but it can be a trigger for hot flashes,” she says. The same goes for smoking, alcohol, and spicy foods. It’s best to eat as healthy as possible and try to exercise, she adds. Some patients see improvement in symptoms once they make lifestyle changes.
Try to de-stress
Anxiety is a common menopause symptom—blame the hormone changes. To make matters worse, research suggests women experience more hot flashes when they’re stressed. One proactive way to combat that is to build time into your schedule so you don’t have to rush around, says Dr. Robin Noble, chief medical officer of Let’s Talk Menopause, a national nonprofit that promotes greater understanding of menopause, plus more comprehensive care. That can help lower the chance of an anxiety attack when you’re, say, dashing to catch the train.
Meditating or experimenting with different breathing techniques are also effective ways to reduce stress, Noble says. She recommends trying box breathing when you start to feel your anxiety levels spiking: Breathe in through your nose while counting to four, hold your breath for four seconds, and then exhale through your mouth to a count of four, and hold your breath again for that length of time. Repeat until you feel calm.
Wear a damp bathing suit under your clothes
Since entering perimenopause, Tawni Pargman has noticed that she’s warmer all the time. She sleeps with her window open year round (even in the cold Spokane, Wash. winters) and wears a tank top or T-shirt when other people have hoodies on. So when she walks her yellow labrador in the summer, she wears a damp bathing suit underneath her clothes. It’s a trick she learned from her mother. “Back in the ‘80s, she would do that too,” says Pargman, 46. “It doesn’t need to be soaking—but that coolness on your skin makes such a huge difference.”
Take an extra outfit with you (or get rid of it altogether)
Cerbelli regularly overheated so much that her coworkers feared she might be having a heart attack or stroke. “You feel the wetness going down your body, your armpits,” she says. “I would be drenched. I used to carry extra clothing in case I needed to change.”
Read More: What to Wear When It’s Really Hot Outside
That resonates with Karen Giblin, 70, who’s president and founder of Red Hot Mamas, which provides menopause education and support programs in the U.S. and Canada. Giblin used to work in local government, and she always took a second set of clothes to town meetings. Before going home, she would strip down in the bathroom for a few minutes. “I put my body up against the tile,” she recalls. She also accepted the fact that sometimes, when she was at home, she’d have no choice but to rip off her clothes. “If the FedEx man came to the door, I thought, ‘Oh, my God. What am I going to do?’ And I don’t think I’m an anomaly. I think other women have had to strip down to nearly nothing.”
Hit the grocery store freezer
If you’re out running errands on a summer day and a hot flash strikes, what do you do? Cerbelli devised a creative solution: She ducked into the nearest supermarket, opened the freezer doors, and flung herself in. “I put my whole body in there,” she recalls. “The funny part was, one time, a few doors down there was another woman in the freezer.” There were certainly some strange looks from other shoppers—but after a few minutes, she had cooled down, so it was worth it.
If you’re spending time outside, get your hair wet
Pargman likes backpacking the trails of Washington with her family, and she’s learned an important lesson: Always hike with wet hair. She usually dips hers in the first stream she comes across, and finds it keeps her cool for hours. “It makes such a huge difference in your energy levels,” she says. Plus, it’s armor against potential hot flashes.
Seek out cool activities
Giblin entered menopause after undergoing a hysterectomy at age 40, and she quickly started experiencing 20 to 30 hot flashes a day; each one lasted about three minutes. In the thick of her recovery from surgery, she thought to herself: “Where am I going to cool off?” It dawned on her that she had always loved ice-skating, and that it would be an ideal life stage for her to return to the cold rink. She started spending hours a week gliding around the ice. “It did put out the fire,” she says. “I never, ever got a hot flash while ice skating. It was my secret weapon for my hot flashes.”
Test out cooling products
A few years ago, Giblin did a segment for QVC focusing on her favorite cooling products for menopausal women. After a while, the segment started airing overnight—and she wondered who would possibly see it. But it turned out that viewers bought more in the middle of the night than they did during the daytime—likely because they were awake, hot, and unable to sleep.
Read More: How to Spend Time Outside if You Hate Getting Sweaty
New cooling products are marketed constantly, and Giblin notes that it can be worth experimenting to figure out which make a difference for you. Many people find relief by wearing battery-operated neck fans, for example, or carrying tiny fans they can whip out of their purse when they feel a hot flash coming. Embr Wave makes cooling bracelets that claim to provide on-demand temperature relief; there are even cooling pearls you can freeze before wearing. You might also like slipping discreet gel pads into your bra—the ones made by Opal Cool can drop to 58°F after being refrigerated. The company is known, too, for cool wraps designed to be worn around your upper neck and shoulders, plus frosty eye masks that can improve long, hot nights. Spend some time researching your biggest pain points, and you might be surprised at the innovations that have popped up to help alleviate them.
Ask your doctor about treatment options
If you’ve made lifestyle changes and lowered your stress levels, but you’re still experiencing persistent hot flashes, ask your doctor about prescriptive therapies, Burroughs advises. Among the options: hormone replacement therapy, low-dose selective serotonin reuptake inhibitors (SSRIs), gabapentin, clonidine, and fezolinetant. Ideally, these treatments would completely eliminate hot flashes, but people respond differently. “The more intense your symptoms, the harder it could be to get them under control,” she says. But that doesn’t mean it’s not worth trying.
Burroughs wants people to know that they’re not destined to suffer, even on the hottest summer days. “Yes, it’s a natural part of transitioning, but that doesn’t mean symptoms have to be tolerated,” she says. “Don't feel as if just because this was designed biologically, that we can't help you make the easiest transition possible.”
More Must-Reads from TIME
- Caitlin Clark Is TIME's 2024 Athlete of the Year
- Where Trump 2.0 Will Differ From 1.0
- Is Intermittent Fasting Good or Bad for You?
- The 100 Must-Read Books of 2024
- Column: If Optimism Feels Ridiculous Now, Try Hope
- The Future of Climate Action Is Trade Policy
- FX’s Say Nothing Is the Must-Watch Political Thriller of 2024
- Merle Bombardieri Is Helping People Make the Baby Decision
Contact us at letters@time.com