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If hot flashes remain significantly disruptive despite using these approaches, then prescription hormone therapy or nonhormone prescription drugs can be considered: Weight loss Cognitive-behavioral therapy Clinical hypnosis Other measures are sometimes encouraged or tried for hot flashes but have limited solid data available to evaluate their effectivenessor they have failed to show significant benefits in clinical trials: Acupuncture Chiropractic interventions Cooling techniques, such as adjusting clothing or environmental temperature Dietary modifications Dietary supplements such as ammonium succinate, black cohosh, cannabinoids such as marijuana, chasteberry, dong quai, evening primrose, ginseng, Lactobacillus acidophilus , maca, milk thistle, omega-3 fatty acid, pollen extract, rhubarb, vitamin E, and wild yam (dioscorea) Exercise and yoga Mindfulness-based interventions Paced breathing Relaxation techniques Soy foods, soy extracts, and soy metabolite equol (S-equol) Trigger avoidance, such as alcohol, caffeine, spicy foods, or hot foods Thats not to say that none of these measures have value

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Either active smoking or exposure to secondhand smoke is associated with colonization by potentially pathogenic bacteria [3,4,5]