New Guidelines Provide Doctors with Additional Treatment Options for Hot Flashes

Dorian Martin Health Guide
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    Fighting off a hot flash right now? Your doctor may offer you some additional treatment options, thanks to a new set of guidelines published in the January 2014 issue of Obstetrics & Gynecology. These guidelines offer updated recommendations of recommended treatments to assist women with those pesky hot flashes and night sweats as they go through the menopausal transition.


    The guidelines point out that between 50 percent and 82 percent of U.S. women who go through natural menopause describe experiencing vasomotor symptoms (hot flashes and night sweats).  These symptoms increase during the perimenopausal period leading up to the menopausal transition and then peak approximately one year after a woman has her final menstrual period. However, the symptoms can last for up to a decade after ta woman goes through the menopausal transition.

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    The guidelines point to growing evidence that some antidepressants and medications used for other purposes can aid in dealing with hot flashes. The U.S. Food and Drug Administration has approved the use of paroxetine (Paxil), which is an antidepressant, for the treatment of hot flashes. The Los Angeles Times reported that clinical trials found that a 7.5-milligram dose (which is much lower than the typical dosage of 30-40 milligrams used to treat depression) reduced the frequency of hot flashes in women who experienced at least seven of these episodes daily. The reduction was by 57 percent to 59 percent. However, Paxil can have side effects, including a possible increased risk of osteoporotic fractures and reduced sex drive.


    Researchers also have found that low doses of antidepressants such as venlafaxine (Effexor) or fluoxetine (Prozac) can bring relief to some women. Furthermore, gabapentin (an anti-seizure drug) and clonidine (which is prescribed to treat high blood pressure) also can ease vasomotor symptoms.


    The guidelines still reinforce previous findings that hormone therapy – either estrogen alone or estrogen plus progestin – is still the most effective treatment to ease women’s hot flashes. The Los Angeles Times pointed out that women who take hormone replacement therapy can see between 65 percent and 80 percent reduction in hot flashes and night sweats.


    “But for women plagued by hot flashes yet concerned about the increased risk of heart disease, stroke, blood clots and breast cancer associated with HRT use, a low-dose antidepressant may be a good alternative,” the Los Angeles Times reported.


    So what should you do if you’re in the menopausal transition and you’re experiencing hot flashes or night sweats? Here are some suggestions:

    • Talk to your doctor about the best treatment recommendations based on your individual case.
    • Analyze your lifestyle. Food and drink can trigger hot flashes. For instance, I recently went to a holiday open house at some friends’ home. While there, I enjoyed two mugs of their famous (and very tasty) egg nog. That night, I woke up in the middle of the night with night sweats. I rarely get these, but it seems like they always seem to trigger whenever I drink certain types of alcohol. In this case, my friends’ eggnog was not the “virgin” type; they had added bourbon to it. I’ve also previously noticed that I tend to have night sweats if I drink a cocktail that includes vodka. Beer also can cause me to wake up sweating. However, tequila doesn’t trigger a reaction. And my go-to happy hour beverage – which doesn’t cause night sweats – is a glass of wine. Really spicy foods and fried foods also sometimes cause me to have night sweats so I only rarely eat these types of foods.
    • Investigate natural treatments.The North American Menopause Society points out that some natural treatments may be helpful in treating hot flashes. These include black cohost, red clover and ginseng. However, you need to be careful since there are risks involved. “Keep in mind that herbal supplements are not as closely regulated as prescription drugs,” the NAMS website stated. “The amount of herbal product, quality, safety, and purity may vary between brands or even between batches of the same brand.” The NAMS warns of potential interactions between herbal remedies and prescription drugs. Therefore, you need to tell your healthcare provider about all any botanical therapies you are taking or are considering taking.

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    Healy, M. (2013). FDA approves an antidepressant for hot flashes. Los Angeles Times.


    MedlinePlus. (2013). Experts lay out options for menopause symptoms.


    North American Menopausal Society. (ND). Do Mother Nature’s treatments help hot flashes?


    Obstetrics & Gynecology. (2014). Practice bulletin no. 141: Management of menopausal symptoms.

Published On: December 26, 2013