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Hot Flashes and Menopause (cont.)

Herbal Supplements for Hot Flashes

Patient Comments

Many women turn to alternative therapies for the treatment of hot flashes. These have included herbal products, vitamins, and plant estrogens as well as other substances. Doctors can be reluctant to recommend alternative treatments because these nonprescription products are not controlled by the U.S. Food and Drug Administration (FDA). Because they are not regulated like prescription medications, their ingredients and strength can vary from manufacturer to manufacturer and testing and proof of safety is not required for marketing of these products as it is with prescription medications. Long-term, scientifically controlled studies for these products are either lacking or have not proved the safety and effectiveness of the product.

Some popular alternative treatments for menopausal hot flashes include:

  • Plant estrogens, known as phytoestrogens. This broad category includes different types of compounds found in soy products, red clover, and flaxseed. Some studies have shown that these compounds may help relieve hot flashes and other symptoms of menopause. However, some phytoestrogens can actually have anti-estrogenic properties in certain situations, and the overall risks of these preparations have not yet been determined.
  • Black cohosh has been widely used in Europe and is becoming increasingly popular in the U.S. The North American Menopause Society does support the short-term use of black cohosh for treating menopausal symptoms, for a period of up to six months. While some studies have shown that black cohosh can reduce hot flashes, most studies have not been considered to be stringent enough in their design to firmly prove any benefit. There have also not been adequate scientific studies that establish the long-term benefits and safety of using black cohosh.
  • Vitamin E supplements have been used by some women to provide relief from hot flashes, but scientific studies are lacking to prove the effectiveness of vitamin E in relieving hot flashes.
  • Other alternative remedies for hot flashes have included including

Scientific studies to prove the safety and effectiveness of these products have not been performed.

Bioidentical Hormone Therapy

Patient Comments

There has been increasing interest in recent years in the use of so-called "bioidentical" hormone therapy for perimenpausal 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 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.

What about lifestyle changes to reduce hot flashes?

Some women report that exercise programs or relaxation methods have helped to control hot flashes, but controlled studies have failed to show a benefit of these practices in relieving the symptoms of hot flashes. Maintaining a cool sleep environment and the use of cotton bedclothes can help ease some of the discomfort associated with hot flashes and associated night sweats.

Can Hot Flashes Be Prevented?

It is impossible to predict which women will experience hot flashes in association with the perimenopause or the degree of severity of the hot flashes. Perimenopausal hot flashes may be controlled by some of the treatment measures described above, but are not preventable.

Do Hot Flashes Go Away?

Hot flashes associated with the menopausal transition are not a life-long problem and can be effectively treated in most women if necessary. About 80% of women will stop having hot flashes five years after the onset of hot flashes. Less commonly, in about 10% of women, hot flashes can persist for up to a decade.

REFERENCE: Stanten, R. J., et al. "Menopausal hot flashes." UpToDate. Updated Marc 27, 2015.
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Medically Reviewed by a Doctor on 9/11/2017
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Patient Comments & Reviews

The eMedicineHealth doctors ask about Hot Flashes (Menopause):

Hot Flashes - Diagnosis

How was your hot flashes diagnosed?

Hot Flashes - Herbals and Supplements

What herbal products or supplements have helped ease your hot flashes?

Hot Flashes - Prescription Medications

What prescription medications have helped reduce your hot flashes?

Hot Flashes - Bioidentical Hormone Therapy

Did/does bioidentical hormone therapy help with your hot flashes?

Hot Flashes - Symptoms

What do your hot flashes feel like?

Hot Flashes - Describe Your Experience

Please describe your experience with hot flashes.



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