As long as there have been hot flashes, menopausal women have been passing down secrets on how to cure them: plants, herbs, nuts, grains, magnets, exercises, health food stores and pharmacies.

Here’s what modern medicine has found so far.

• Hormone replacement therapy: Since a drop in estrogen is the cause, it’s also the most effective treatment, reducing hot flashes by at least 75 percent. But it has been linked to heart disease, breast cancer and stroke.
• Anti-depressants: Studies show that selective serotonin reuptake inhibitors reduce the frequency and severity of hot flashes by up to 75 percent. The studies were done in cancer patients who were unable to take estrogen therapy.
• Soy: Soy proteins or extracts are popular because they contain estrogen-like substances called isoflavones. One study found that women who ate soy flour had a 40 percent reduction in hot flashes. Women with soy-rich diets have claimed similar benefits. However, most studies have found that it’s not much better than a placebo.
• Red clover: Another source of isoflavones. Scientists recently tested Promensil, a supplement made from red clover, and found it reduced hot flashes more rapidly than did a placebo. But they concluded it had no significant effect because after 12 weeks, everybody reported the same drop in hot flashes.
• Other plant-based estrogens: Foods such as alfalfa, fennel, celery, parsley, whole grains and apples all have estrogen-compounds known as phytoestrogens.
• Black cohosh: A few studies suggest this herb works better than a placebo; though scientists have questioned the findings. In Germany, it’s an approved treatment.

– Sources: Mayo Clinic Proceedings, November 2002, and the Journal of the American Medical Assn.