It’s difficult to give a definite answer to this question, as it’s so variable. About 1 in 4 women get no hot flushes at all; for most, they tend to settle within 2-3 years of the menopause; and for some, they never go away completely. There has been good news about treatments in the last year on two fronts. HRT is statistically the most effective treatment for hot flushes. However, about 10 years ago two studies raised concerns that HRT, especially in the long term, might increase the risk of breast cancer and heart attack. However, follow up analysis has shown that for women who take HRT around the menopause, there is no increased risk of heart disease and the increased risk of stroke is in the order of 1 in 1000. In addition, doubt has been cast on the findings about breast cancer and within the last few months, a Danish study involving 20,000 ‘patient years’ of HRT treatment showed no increased risk of breast cancer from taking HRT. Soya products have long been used as a ‘natural’ remedy for hot flushes, and do appear to be effective for many women at reducing the severity and frequency of hot flushes. However, since soya isoflavones are closely related to oestrogen, there has been concern that soya, too, might increase the risk of breast cancer. However, a recent review by the American Cancer Society has found no evidence of a link between increasing your dietary intake of soy products and breast cancer. Other options might include red clover isoflavone or black cohosh – you can get these from many pharmacists, but do make sure you buy a product that have a certification make from the MHRA’s ‘Traditional Herbal Medicines Registration Scheme’ so you can be sure they’ve been assessed as produced safely. An example of these is Menoherb by Schwabe, which contains black cohosh.