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Hot Flashes (cont.)

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What are the treatments for hot flashes?

There are a variety of treatments for hot flashes such as:

  • hormone therapy,
  • bioidentical hormone therapy,
  • other drug treatments,
  • complementary and alternative treatments,
  • phytoestrogens,
  • black cohosh, and
  • alternative therapies.

Some of these have not been tested by clinical studies, nor are they approved by the US Food and Drug Administration (FDA).

Hormone therapy for hot flashes

Traditionally, hot flashes have been treated with either oral or transdermal (such as a patch) forms of estrogen. Hormone therapy (HT) or postmenopausal hormone therapy (PHT), formerly referred to as hormone replacement therapy (HRT), consists of estrogens alone or a combination of estrogens and progesterone (progestin). All available prescription estrogen medications, whether oral or transdermal, are effective in reducing the frequency of hot flashes and their severity. Research indicates that these medications decrease the frequency of hot flashes.

However, long-term studies (the NIH-sponsored Women's Health Initiative, or WHI) of women receiving 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 hormone therapy. 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.

More recently, it has been noted that the negative effects associated with hormone therapy were described in older women who were years beyond menopause, and some researchers have suggested that these negative outcomes might be lessened or prevented if hormone therapy was given to younger women (prior to or around the age of menopause) instead of women years beyond menopause.

The decision in regard to starting or continuing hormone therapy, therefore, is an individual one in which the patient and doctor must take into account the inherent risks and benefits of the treatment along with 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.

Bioidentical hormone therapy for hot flashes

There has been increasing interest in recent years in the use of so-called "bioidentical" hormone therapy for perimenopausal women. Bioidentical hormone preparations are medications that contain hormones that have the same chemical formula as those made naturally in the body. The hormones are created in a laboratory by altering compounds derived from naturally-occurring plant products. Some of these so-called bioidentical hormone preparations are U.S. FDA-approved and manufactured by drug companies, while others are made at special pharmacies called compounding pharmacies, which make the preparations on a case-by-case basis for each patient. These individual preparations are not regulated by the FDA, because compounded products are not standardized.

Advocates of bioidentical hormone therapy argue that the products, applied as creams or gels, are absorbed into the body in their active form without the need for "first pass" metabolism in the liver, and that their use may avoid potentially dangerous side effects of synthetic hormones used in conventional hormone therapy. However, studies to establish the long-term safety and effectiveness of these products have not been carried out.

Medically Reviewed by a Doctor on 6/30/2017

Source: MedicineNet.com
http://www.medicinenet.com/hot_flashes/article.htm

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