Alternative Treatments for Hot Flashes (cont.)
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
William C. Shiel Jr., MD, FACP, FACR
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
In this Article
- Alternatives for treating hot flashes facts
- Introduction to menopause and hot flashes
- What are hot flashes?
- How are hot flashes usually treated?
- Which alternative prescription medications are effective in treating hot flash symptoms of menopause?
- Why are some doctors reluctant to recommend nonprescription therapies for menopause symptoms?
- What alternative treatments for menopause have been scientifically studied?
- Find a local Obstetrician-Gynecologist in your town
What are hot flashes?
Hot flashes are experienced by many women, but not all women undergoing menopause have this experience. A hot flash is a feeling of warmth that spreads over the body, but is often most strongly felt in the head and neck regions. Hot flashes may be accompanied by perspiration or flushing. On average, they usually last from 30 seconds to several minutes. Although the exact cause of hot flashes is not fully understood, they are thought to be due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels. What is known is they can vary in severity, frequency, and duration.
"About 70 percent of women experience hot flashes, but their underlying physiology isn't well understood," said Rebecca Thurston, an assistant professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh.
Sometimes hot flashes are accompanied by night sweats (episodes of drenching sweats at nighttime). This may lead to awakening and difficulty falling asleep again, resulting in unrefreshing sleep and daytime tiredness.
How are hot flashes usually treated?
Traditionally, hot flashes have been treated with oral (by mouth) or transdermal (patch) forms of estrogen. Hormone therapy (HT), also referred to as hormone replacement therapy (HRT) or postmenopausal hormone therapy (PHT), consists of estrogens or a combination of estrogens and progesterone (progestin). Oral and transdermal estrogen are available as estrogen alone or estrogen combined with progesterone. Whether oral or transdermal, all available prescription estrogen replacement medications are effective in reducing hot flash frequency and severity.
However, long-term studies (NIH-sponsored Women's Health Initiative, or WHI) of women receiving oral preparations of combined hormone therapy with both estrogen and progesterone were halted when it was discovered that these women had an increased risk for heart attack, stroke, and breast cancer when compared with women who did not receive HT. Later studies of women taking estrogen therapy alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer. Estrogen therapy alone, however, is associated with an increased risk of developing endometrial cancer (cancer of the lining of the uterus) in postmenopausal women who have not had their uterus surgically removed.
The decision in regard to starting or continuing hormone therapy, therefore, is a very individual choice in which the patient and doctor must take into account the inherent risks and treatment benefits, plus each woman's own medical history. It is currently recommended that if hormone therapy is used, it should be used at the smallest effective dose for the shortest possible time.
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