Why Women Seek Treatment For Hot Flashes
Although theyre a completely normal part of the menopausal transition, hot flashes feel anything but normal, especially when they may also come with nausea, anxiety and chills .
Dont worry your hot flash symptoms will subside. But while its happening, a hot flash may feel like it will never end. Thats because although some hot flashes recede in 30 seconds, some can last for as long as 10 minutes.
Hot flashes may hit once in a while, or they may plague you all throughout the day and night.
Hot flashes can be moderate to severe .
Although hot flashes usually subside and get less bothersome within a few years of reaching menopause, some women will continue to get them for 10 years or more.
Nk3 Receptors: A Promising Non
Human and animal studies have shown that a reduction in oestrogen levels as a result of menopause causes a rise in the production of neuropeptide neurokinin-B . This in turn causes NK-B to over-activate neurokinin-3 and cause dysfunctional and excessive heat dissipation. Therefore, suggesting that blocking NK3 using a receptor antagonist could restore normal thermoregulation in women with menopause.
This discovery has been seized upon by both pharma companies and academic researchers as a possible target for new non-hormonal therapies two examples of advanced NK3 receptor antagonist programmes are Astellas fezolinetant and Imperial College Londons study of AstraZeneca and Millendo Therapeutics MLE4901.
Japanese Astellas gained the rights to fezolinetant as a candidate for menopause-related VMS when it acquired Belgian Ogeda in May 2017 fezolinetant was the companys primary clinical development programme.
In a Phase IIb trial, fezolinetant met the US Food and Drug Administration -recommended co-primary endpoints of mean decrease in frequency and severity of VMS in post-menopausal women at both week four and week 12 these results were presented at the Endocrine Societys annual ENDO meeting in March 2019.
Lead investigator of the study and Denver-based gynaecologist Arthur Waldbaum commented: The study findings presented at ENDO are promising as they suggest that fezolinetant may have the potential to address these symptoms as early as one week.
Natural Alternatives To Hormones
The mechanism by which hormones improve menopausal symptoms isnt completely understood, but we know three possible components now: 1) they may increase the thermoneutral zone, or at least stabilize the blood vessels so they arent so hyperreactive 2) they may stabilize the levels of catecholamines or 3) they may stabilize serotonin levels. I havent seen any non-hormonal therapies that seem to operate on catecholamine concentrations but here are those that fit into the other two categories, plus a few that dont seem to fit elsewhere.
Action On Blood Vessels:
- Grape seed extract. This is the most promising possibility that Ive seen in this category, due to this study. The active ingredient, proanthocyanidins, improve circulation by vasodilation . Its therefore also good for coronary artery disease.
- Hesperidin. As far as I can tell, theres only ever been one study on this, and it was done in conjunction with Vitamin C. This study shows that hesperidin, an extract of citrus rind, produces nitric oxide. This is a vasodilator as well.
- Magnesium. This study shows a 41.1% decrease in hot flash symptoms with magnesium. Its not spectacular, but since magnesium is a vasodilator, that is the probable mechanism of action.
- Arginine? This is just speculation on my part, but if nitric oxide helps to stabilize blood vessels, and this is part of the mechanism of hot flashes then it might be worth a try.
Action on Serotonin:
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How Do I Cope With Mood Swings Fears And Depression
Many people experience a wide variety of symptoms during menopause, not just hot flashes. Mood swings, depression, anxiety and fears are all possible symptoms you might experience throughout menopause. Its alright if you have these symptoms. Menopause is a time of extreme change and transition for your body. If you feel overwhelmed by any of these symptoms at any point, reach out to your healthcare provider. There are ways to help you feel better.
There are also a few ways you can cope with mood swings, depression and fear during menopause at home. These things include:
- Finding a self-calming skill to practice, like yoga, meditation or slow, deep breathing exercises.
- Avoiding tranquilizers, if possible.
- Engaging in creative outlets that foster a sense of achievement.
- Staying connected with your family, friends and community.
Another symptom of menopause that you might experience is painful intercourse. If you find that sex is uncomfortable or painful, there are things you can do to make it better. Try using a vaginal water-based moisturizing lotion or lubricant during intercourse. These are sold without a prescription. Common names include Astroglide® and KY liquid®. Its recommended that you avoid Vaseline® as a lubricant because it could lead to yeast infections.
Bioidentical Or Natural Hormones
Bioidentical hormones are hormone preparations made from plant sources that are promoted as being similar or identical to human hormones.
Practitioners claim these hormones are a “natural” and safer alternative to standard HRT medicines.
However, bioidentical preparations are not recommended because:
- they are not regulated and it’s not clear how safe they are there’s no good evidence to suggest they’re safer than standard HRT
- it’s not known how effective they are in reducing menopausal symptoms
- the balance of hormones used in bioidentical preparations is usually based on the hormone levels in your saliva, but there’s no evidence that these levels are related to your symptoms
Bioidentical hormones are not the same as body identical hormones. A body identical hormone, or micronised progesterone, can be prescribed to treat menopausal symptoms.
Many standard HRT hormones are made from natural sources, but unlike bioidentical hormones, they’re closely regulated and have been well researched to ensure they’re as effective and safe as possible.
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What Causes Hot Flashes
Its not exactly clear what causes hot flashes. Multiple studies are attempting to understand them. There is clear evidence that hot flashes result from hormonal changes in the body. Their connection to other health problems, such as diabetes, is also being studied. Obesity and metabolic syndrome are thought to increase the incidence of hot flashes. Some women barely notice hot flashes or consider them a minor annoyance. For others, the intensity may affect their quality of life in a rather negative way.
- smoking or being exposed to cigarette smoke
You may want to start keeping a journal about your symptoms. Write down what you were doing, eating, drinking, feeling, or wearing when each hot flash began. After several weeks, you may begin to see a pattern that can help you avoid specific triggers.
Hot Flushes And Night Sweats
A hot flush is a sensation of heat involving the whole body and may be associated with redness and sweating. Night sweats are episodes of profuse sweating at night, either alone or just after a hot flush. These symptoms range in severity from minor irritation to a major disruption in quality of life.
- Oestrogen withdrawal. The cause of hot flushes is not completely understood but is related to oestrogen withdrawal. Declining estrogen levels are thought to impact on the brain temperature regulatory centre making both sweating and shivering more common. Centrally acting neurotransmitters including noradrenaline and serotonin are believed to be involved.
- Other conditions. Not all hot flushes are due to menopause. Other associated conditions include thyroid disease, diabetes, hyperhidrosis , anxiety and panic disorders, obesity, hormonally active tumors, chronic infections and neurological disorders.
- Medications. Some medicines can cause hot flushes or make them worse. These include anti-oestrogens: tamoxifen , aromatase inhibitors, toremifene , raloxifene and clomiphene and the gonadotrophin-releasing hormone analogues i.e. goserelin, leuprorelin and nafarelin1. Some non-hormonal treatments for hot flushes, such as venlafaxine, can also cause hot flushes at higher doses. Some men who undergo treatments for prostate cancer experience hot flushes.
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Can You Stop Menopause Hot Flashes Without Hrt
In fact, Relizen® is just that! This over-the-counter nutritional supplement is the real deal when considering a really, truly hormone-free option for managing hot flashes and managing your day-to-day quality of life, including improved sleep! Made from a proprietary pollen blend extracted from four specific Swedish plants, and likely working through serotonin-like pathways in the brain, Relizen® has been shown in several clinical studies to reduce the frequency and intensity of menopausal hot flashes by more than 70%.1 In fact, results were so notable that a significant number of women in additional survey studies opted to remain on Relizen® for the treatment of their hot flashes voluntarily once the studies were completed.2 Of equal importance, side effects different from placebo were not reported and use in breast cancer patients is not controversial since Relizen® is not a phytoestrogen and does not act like estrogen in the body.
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Treatment With Synthetic Compounds With Partial Estrogenic Activity
The minimum requirements for the clinical evaluation of new products in the treatment of vasomotor symptoms have been defined by the Food and Drug Administration and the European Medicines Agency ). Besides the definition of outcome parameters and the methods of their evaluation, these guidelines set standards requiring at least 12 weeks of treatment for a randomised controlled clinical trial. This considers the need for chronic treatment in this indication. Many of the academia-driven studies have been performed with shorter treatment durations, and could therefore be considered as providing merely supportive evidence.
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Exercise Relaxation Techniques And Behavioral Therapies
Some women find these types of approaches help them with menopausal symptoms. Although there is only limited research showing these techniques might be helpful, theres likely to be little harm in trying them. Before starting any exercise program after being diagnosed with breast cancer, its important to speak with your doctor or someone on your health care team.
Some research has suggested that acupuncture might be helpful in treating hot flashes, although not all studies have found this. This might be another option to discuss with your doctor.
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Ht Of Climacteric Symptoms And Risk Of Breast Cancer
As early as 1997, initial epidemiologic evidence showed that HT may increase the risk of breast cancer. One meta-analysis of 51 epidemiologic studies comparing data from 52,705 women with breast cancer, and including 108,411 women without breast cancer, revealed that the prevalence of breast cancer was significantly increased in women using HT, and rose with duration of use. Several subsequent studies have confirmed these data.
The large prospective Womens Health Initiative trial that included 16,608 post-menopausal women was prematurely terminated due to a significantly increased risk of breast cancer development 1.26 1.00-1.59), coronary heart disease ), stroke ) and venous thromboembolic disease ) in the hormone-treated arm .
Several other prospective und epidemiological studies confirmed these findings for a review, cf. .
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Experts Are Excited About Hot Flash Trial Results
Hot flashes and night sweats can disrupt womens sleep and can lead to anxiety, irritability, loss of productivity, and depression, according to research published in Health Quality of Life Outcomes. At the annual meeting, NAMS cited the research as one of the top abstracts presented at the 2019 NAMS meeting. We havent had anything new in the hot flash world in quite some time. This is a new drug that is different and works in a different way, so we are hopeful it will come to market, says Faubion.
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Have You Used Effexor For Hot Flashes
If youve used Effexor as a treatment for hot flashes, share your experience in the comments section below. Mention whether you have an underlying neuropsychiatric condition along with hot flashes, or solely hot flashes that were being treated with Effexor. Document how Effective you perceived the Effexor to be as a treatment for hot flashes, as well as any additional favorable benefits you noticed while taking it .
Also share any unwanted side effects you experienced as a result of Effexor. To help others get a better understanding of your situation, share the dosage of Effexor that youre taking as well as whether youre taking other medications and/or supplements. Have you tried any other treatments for hot flashes such as hormone replacement therapy or alternative interventions such as acupuncture?
Realize that there is ample evidence to support the usage of Effexor for the treatment of hot flashes. However, if hot flashes are the only condition youre treating with Effexor, you may want to reconsider treatment and the consequences associated with using a potent antidepressant as a non-hormonal intervention . Do you think Effexor should be used as a treatment for hot flashes? Why or why not?
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Using Hormones To Treat Hot Flashes And Night Sweats
Some women may choose to take hormones to treat their hot flashes or night sweats. A hormone is a chemical substance made by an organ like the thyroid gland or ovary. During the menopausal transition, the ovaries begin to work less effectively, and the production of hormones like estrogen and progesterone declines over time. It is believed that such changes cause hot flashes and other menopausal symptoms.
Hormone therapy steadies the levels of estrogen and progesterone in the body. It is a very effective treatment for hot flashes in women who are able to use it. They can also help with vaginal dryness, sleep, and maintaining bone density.
Hormone treatments can take the form of pills, patches, rings, implants, gels, or creams. Patches, which stick to the skin, may be best for women with cardiac risk factors, such as a family history of heart disease.
There are risks associated with taking hormones, including increased risk of heart attack, stroke, blood clots, breast cancer, gallbladder disease, and dementia. Women are encouraged to discuss the risks with their health care provider. The risks vary by a woman’s age and whether she has had a hysterectomy. Women who still have a uterus would take estrogen combined with progesterone or another therapy to protect the uterus. Progesterone is added to estrogen to protect the uterus against cancer, but it also seems to increase the risk of blood clots and stroke.
Natural Remedies And Complementary Medicine
In 2004, Fugate and Church assessed the efficacy and safety of non-hormonal, non-oestrogen treatments of menopause-associated vasomotor symptoms in a systematic review . This review included non-prescriptional as well as prescriptional treatments , and venlafaxine. However, in contrast to the present review, studies in cancer patients were explicitly excluded.
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Prescribing Nk3 Antagonists After Hrt
Originally developed for schizophrenia, its action against NK3 led to Imperial researchers, in collaboration with the pharma developers, to identify NK3 antagonist MLE4901 as a potential candidate against menopause-related VMS.
In a study carried out between 2016 and 2017 led by Imperial professor Waljit Dhillo, MLE4901 reduced the frequency of hot flushes by 50% in just three days and by 75% over four weeks in post-menopausal women aged between 40 and 62 who reported having seven or more bothersome hot flushes per day.
Dhillo commented: We already knew this compound could be a game-changer for menopausal women, and get rid of three-quarters of their hot flushes in four weeks. But this new analysis confirms the beneficial effect is obtained very quickly within just three days.
Lead author of the study, which was published in the journal Menopause, Dr Julia Prague added: To see the lives of our participants change so dramatically and so quickly was so exciting, and suggests great promise for the future of this new type of treatment.
In addition to reducing the frequency of hot flushes, MLE4901 was able to mitigate the severity of this VMS, as well as improve sleep quality women involved in the study reported an 82% decrease in the amount hot flushes interrupted their sleep.
Treatments For Menopausal Symptoms
There are several drug-free ways to reduce the impact of hot flushes and night sweats. These include:
- Counselling and psychological treatment such as cognitive behaviour therapy .
- Hypnosis may also be helpful.
- Some women also benefit from acupuncture.
Whilst paced breathing, exercise and relaxation programs may be helpful for your general physical and emotional health, they do not significantly reduce menopausal symptoms.
Non-hormonal drug treatments
Several prescription medications have been shown to reduce hot flushes and night sweats. Unfortunately, these do not improve vaginal dryness. Prescription medications for hot flushes and sweats include:
- certain antidepressants
- a drug called gabapentin
- a blood pressure medication called clonidine.
These drugs may reduce hot flushes and nights sweats from around 40-60 per cent . Using antidepressants and using treatments that improve sleep may also improve mood.
For more information see the fact sheet Treating hot flushes: An alternative to menopausal hormone therapy
Menopausal Hormone Therapy
Menopausal hormone therapy contains oestrogen to treat menopausal symptoms and may contain a progestogen to protect the lining of the uterus from cancer in women who have not had a hysterectomy. Menopausal hormone therapy is also known as hormone replacement therapy or hormone therapy .
See the fact sheet Menopausal Hormone Therapy for more information on:
Compounded or bioidentical hormone therapy
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Can I Prevent Hot Flashes At Night
Hot flashes can also interfere with your sleep. You might hear this referred to as night sweats or even insomnia. There are a few environmental and lifestyle changes you can make that can help you sleep better each night. These changes include:
- Keep your bedroom cool to prevent night sweats.
- Avoid using sleeping pills.