Does olive oil help with hot flashes during perimenopause?

Hot flashes are the hallmark symptom of perimenopause, caused by the hypothalamus's thermoregulatory center becoming hypersensitive to small changes in body temperature as estrogen declines. Extra virgin olive oil does not directly regulate estrogen or the hypothalamus, but there is real evidence suggesting that the dietary pattern it anchors, the Mediterranean diet, is associated with fewer and less severe vasomotor symptoms.

The most relevant evidence comes from Berendsen and colleagues (2017), who analyzed data from the Women's Health Initiative and found that higher adherence to the Mediterranean dietary pattern was associated with a reduced likelihood of reporting troublesome hot flashes and night sweats. Women in the highest Mediterranean diet adherence group had meaningfully fewer vasomotor symptoms than those with low adherence. Olive oil is one of the defining features of the Mediterranean diet, though as with all dietary pattern research, it is not possible to attribute the effect to any single food.

The plausible mechanisms by which olive oil might contribute include its anti-inflammatory effects and its impact on metabolic health. Hot flash frequency and severity are higher in women with greater inflammation and greater adiposity. A diet high in extra virgin olive oil reduces systemic inflammation through its polyphenol content, including oleocanthal, hydroxytyrosol, and oleuropein. Oleocanthal's COX-1 and COX-2 inhibiting properties, documented by Beauchamp and colleagues in Nature (2005), reduce prostaglandin production, which plays a role in inflammatory signaling that may influence thermoregulation.

Olive oil also supports better insulin sensitivity and a healthier lipid profile. Metabolic dysfunction, including insulin resistance, is associated with more severe hot flashes in some studies. By supporting metabolic health broadly, a diet anchored by EVOO may create conditions where the thermoregulatory system is less reactive.

Body weight is also relevant: carrying excess adipose tissue is associated with more severe vasomotor symptoms, possibly because fat tissue acts as an insulator and also contributes to systemic inflammation. Extra virgin olive oil, as part of a Mediterranean-style eating pattern, has been associated with better weight outcomes compared to low-fat diets in long-term studies. The PREDIMED trial showed that Mediterranean diet groups maintained or lost weight over time despite the high fat content of the diet.

It is important to be realistic about what olive oil alone can achieve. Hot flashes driven by significant hormonal shifts are not going to be eliminated by dietary fat. The evidence for EVOO here is indirect and based on dietary pattern research rather than trials isolating the oil. For women with frequent, disruptive hot flashes, dietary changes are unlikely to be sufficient on their own. The strongest evidence for hot flash reduction remains with hormonal therapies and some non-hormonal prescription medications, while dietary changes serve as complementary support.

Practically, choosing cold-pressed extra virgin olive oil and using it generously as your primary dietary fat is an easy place to start. Pairing it with a diet rich in vegetables, legumes, whole grains, and oily fish builds the full Mediterranean pattern that the Berendsen evidence points to. Reducing refined carbohydrates, alcohol, and spicy foods, all of which can trigger hot flashes in some women, complements the approach.

PeriPlan lets you track hot flash timing, intensity, and dietary patterns together, which can reveal whether your eating habits are correlated with better or worse symptom days.

Other lifestyle factors with reasonable evidence for hot flash reduction include regular aerobic exercise, maintaining a cooler sleep environment, stress reduction practices, and, in appropriate women, phytoestrogen-containing foods like soy.

When to see a doctor: Hot flashes that are severe, frequent (more than 7 per day), or significantly disrupting your sleep and daily life deserve a proper conversation with your healthcare provider. Effective treatments exist, and you do not have to simply endure them. Discuss the full range of options, including hormonal and non-hormonal therapies, to find what is appropriate for your health history and preferences.

This content is for informational purposes only and does not replace medical advice. Always consult your healthcare provider about your specific situation.