“There are many ways to treat hot flushes and vaginal
dryness, but no other treatment has been shown to be
as effective as oestrogen replacement therapy”.1

Umbrella
What may the Hot Flushes Treatment Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Complementary and Integrative Health
  • Hormone Replacement Therapy
  • Hormone Therapy
  • Hot Flashes/Flushes Treatment/s
  • NonHormonal Prescriptions
  • Selective Serotonin Reuptake Inhibitors

Cure or Not

Do hot flushes treatments cure hot flushes?

In Menopause FAQs: Hot Flashes – Q. Are There Treatments for Hot Flashes? the North American Menopause Society (NAMS) elaborate on:

Hot Flushes Treatment
“A. Although the available treatments for hot flashes do not cure hot flashes, they do offer relief. Hot flashes usually fade away eventually without treatment, and no treatment is necessary unless hot flashes are bothersome. A few women have an occasional hot flash forever. There are a number of low-risk coping strategies and lifestyle changes that may be helpful for managing hot flashes, but if hot flashes remain very disruptive, prescription drug therapy may be considered”.2

Hormone Therapy

Is hormone therapy (HT) one of the most effective treatments for hot flushes?

In Menopause Management Options: Menopausal Hormone Therapy – How Does MHT Work? the (Australian) Jean Hailes for Women’s Health (JH) note:

“There are many ways to treat hot flushes and vaginal dryness, but no other treatment has been shown to be as effective as oestrogen replacement therapy”.3

On page one in Deciding About Hormone Therapy Use: Potential Benefits, published July 2022, the North American Menopause Society elaborate on:

“Hormone therapy is one of the most effective treatments available for bothersome hot flashes and night sweats. If hot flashes and night sweats are disrupting your daily activities and sleep, HT may improve sleep and fatigue, mood, ability to concentrate, and overall quality of life. Treatment of bothersome hot flashes and night sweats is the principal reason women use HT”.4

Uterus

Hot Flushes TreatmentWhat HT may women who have a uterus be prescribed for hot flushes treatment?

In Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What Is Hormone Therapy? the NAMS elaborate on:

“A. …Women who still have a uterus need to take a progestogen in addition to estrogen or the estrogen-SERM combination to protect against uterine cancer”.5

What is another FDA-approved HT women who have a uterus may be prescribed for hot flushes treatment?

In Menopause FAQs: Hot Flashes – Q. Are There Treatments for Hot Flashes? according to the NAMS:

“A. …Another FDA-approved hormone product for women with a uterus combines estrogen with the selective estrogen receptor modulator bazedoxifene instead of a progestogen. Bazedoxifene is an estrogen agonist/antagonist, which means that it works like estrogen in some tissues while inhibiting estrogen activity in others. In this case, it helps to protect the uterus from cancer”.6

No Uterus

Hot Flushes TreatmentWhat HT may women who do not have a uterus be prescribed for hot flushes treatment?

In Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What Is Hormone Therapy? the NAMS elaborate on:

“A. …Women who have had a hysterectomy (had their uterus removed) can use estrogen alone to control their hot flashes”.7

Hormone Therapy Alternatives

Are HT alternatives available for hot flushes treatment?

In Menopause Management Options: Menopausal Hormone Therapy – Non Hormonal Options: Non-Hormonal Prescription Medication the JH note:

“Some women are told they can’t use hormone-based treatments for menopausal symptoms, such as hot flushes and sweats.

Some women don’t want to take MHT and prefer different treatment options, like non-hormonal prescription medications. These medications take around four weeks to be effective”.8

What are non-estrogen treatments?

In Non-Estrogen Treatments for Menopausal Symptoms the European Menopause and Andropause Society explain:

“Non-estrogen-based treatments are for women who do not wish to take estrogen based menopausal hormone therapy (MHT) either through choice or because of concerns about comorbidities such as venous thromboembolism, or a personal or family history of hormone-dependent cancer (e.g. breast cancer)”.9

Antidepressants SSRIs/SNRIs

What SSRIs/SNRIs are used for hot flushes treatment?

In Menopause Management Options: Menopausal Hormone Therapy – Non Hormonal Options: Non-Hormonal Prescription Medication – Antidepressants the JH explain:

“Some antidepressants have been shown to relieve hot flushes. For example, venlafaxine, paroxetine, escitalopram and fluoxetine. Side effects may include nausea, dry mouth, hot flushes, sweats and insomnia.

Note: Paroxetine and fluoxetine can reduce the effectiveness of some cancer treatment medications”.10

In Hot Flashes: Diagnosis & Treatment – Treatments: Antidepressants the (United States) Mayo Clinic elaborate on:

“A low-dose form of paroxetine (Brisdelle) is the only nonhormone treatment for hot flashes approved by the U.S. Food and Drug Administration. Other antidepressants that have been used to treat hot flashes include:

  • Venlafaxine (Effexor XR)
  • Paroxetine (Paxil, Pexeva)
  • Citalopram (Celexa)
  • Escitalopram (Lexapro)”.11

The Mayo Clinic also note:

“These medications aren’t as effective as hormone therapy for severe hot flashes, but they can be helpful to women who can’t use hormones. Possible side effects include nausea, difficulty sleeping or drowsiness, weight gain, dry mouth or sexual dysfunction”.12

Other Prescription Medications

Apart from SSRIs/SNRIs, what are other prescription medications used for hot flushes treatment?

In Hot Flashes: Diagnosis & Treatment – Treatments: Other Prescription Medication the Mayo Clinic elaborate on:

“Other medications that might offer relief for some women include:

  • Gabapentin (Neurontin, Gralise, others). Gabapentin is an anti-seizure medication that’s moderately effective in reducing hot flashes. Side effects can include drowsiness, dizziness, water retention in the limbs (edema) and fatigue
  • Pregabalin (Lyrica). Pregabalin is another anti-seizure medication that can be effective in reducing hot flashes. Side effects can include dizziness, drowsiness, difficulty concentrating and weight gain
  • Oxybutynin (Ditropan XL, Oxytrol). Oxybutynin is a pill or patch most often used to treat urinary conditions like overactive bladder. It may also help relieve hot flashes in some women. Side effects can include dry mouth, dry eyes, constipation, nausea and dizziness
  • Clonidine (Catapres, Kapvay, others). Clonidine, a pill or patch typically used to treat high blood pressure, might provide some relief from hot flashes. Side effects include dizziness, drowsiness, dry mouth and constipation”.13

Natural Therapies

How effective are natural therapies for hot flushes treatment?

The JH note:

“The use of herbs in menopause is based on longstanding traditional use, some of which is supported by scientific evidence (e.g. a recent study into the effectiveness of red clover). But more research is needed regarding the effectiveness and safety of some herbal therapies for the management of menopausal symptoms”.14

In Menopause: Diagnosis and Management – Information for the Public: Managing Your Symptoms – Hot Flushes and Night Sweats the (British) National Institute for Health and Care Excellence’s (NICE) elaborate on:

“Some women find that the dietary supplements black cohosh and isoflavones can reduce their hot flushes and night sweats. However, the ingredients of these products may vary and their safety is unknown. They may also interfere with any other medicines you are taking”.15

St John’s Wort

Can St John’s wort used for hot flushes treatment?

In Menopause: Diagnosis and Management – Information for the Public: Treating Menopausal Symptoms – Non-Prescribed Treatments: St John’s Wort the NICE explain:

“Some women have found St John’s wort can reduce their hot flushes and night sweats during menopause. However, the ingredients of products containing St John’s wort may vary and their effects are uncertain. Also, these products can interfere with other drugs, including those used to treat breast cancer (for example, tamoxifen)”.16

Mind-Body Practices

How effective are mind and body practices for hot flushes treatment?

In 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. 1 the (United States) National Center for Complementary and Integrative Health (NCCIH) elaborate on:

“Mind and body practices such as hypnosis, mindfulness meditation, and tai chi may help improve some menopausal symptoms. Researchers looked at mind and body therapies for menopausal symptoms and found that tai chi and meditation-based programs may be helpful in reducing common menopausal symptoms including the frequency and intensity of hot flashes, sleep and mood disturbances, stress, and muscle and joint pain. There is also some evidence that hypnotherapy may help women manage hot flashes”.17

On page one and two of the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published 10 June 2022, one of the evidence-based recommendations is:

  • “Alternative therapies, including cognitive behavioural therapy, may also improve hot flushes, nights sweats and other menopausal symptoms and can be considered in women who do not wish to take HRT or have contraindications to taking HRT”.18

Bioidentical Hormones

Are bioidentical hormones or compounded bioidentical hormone replacement therapies recommended for the treatment of hot flushes?

On page four of the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause one of the evidence-based recommendations is:

  • “The use of compounded bioidentical hormone replacement therapies is not recommended given the issues related to their purity, potency and safety. The potential benefits of bioidentical hormone therapy can be achieved using conventionally licensed products available through NHS prescribing without having to resort to compounded varieties from specialist pharmacies”.19

Health Care Provider

What if I would like help with my hot flushes treatment?

If you would like help with your hot flushes treatment, it may be in your best interest to choose to talk to your health care provider about this.

On page one of the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause one of the evidence-based recommendations is:

  • “Women should be advised that implementing or maintaining a healthy lifestyle can improve menopause symptoms. A healthy diet (one low in saturated fat and salt and rich in calcium and vitamin D), stopping smoking, reducing alcohol intake and including regular exercise can be beneficial. Reducing caffeine intake may also improve symptoms”.20

In Hot Flashes: What Can I Do? Treating Menopause Symptoms – What’s Right for Me? the (United States) National Institute on Aging elaborate on:

“Deciding whether and how to treat the symptoms of the menopausal transition can be complicated and personal. Discuss your symptoms, family and medical history, and preferences with your doctor”.21

In 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. 4 the NCCIH remind us:

“Tell all your health care providers about any complementary health practices you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care”.22

Health Topics A-Z

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Links

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Sources

Where may I find the Sources quoted?

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Sources

  1. Menopause Management Options: Menopausal Hormone Therapy – How Does MHT Work? Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes https://www.jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 11 November 2022
  2. Menopause FAQs: Hot Flashes – Q. Are There Treatments for Hot Flashes? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hot-flashes Accessed: 11 November 2022
  3. Menopause Management Options: Menopausal Hormone Therapy – How Does MHT Work? Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes https://www.jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 11 November 2022
  4. Deciding About Hormone Therapy Use: Potential Benefits. 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 11 November 2022
  5. Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What Is Hormone Therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 11 November 2022
  6. Menopause FAQs: Hot Flashes – Q. Are There Treatments for Hot Flashes? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hot-flashes Accessed: 11 November 2022
  7. Menopause FAQs: Hormone Therapy for Menopause Symptoms – Q. What Is Hormone Therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 11 November 2022
  8. Menopause Management Options: Menopausal Hormone Therapy – Non Hormonal Options: Non-Hormonal Prescription Medication. Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes https://www.jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 11 November 2022
  9. Non-Estrogen Treatments for Menopausal Symptoms. 2022. European Menopause and Andropause Society
    https://emas-online.org/wp-content/uploads/2022/05/Non-estrogen-treatments-for-menopausal-symptoms.pdf
    Accessed: 11 November 2022
  10. Menopause Management Options: Menopausal Hormone Therapy – Non Hormonal Options: Non-Hormonal Prescription Medication – Antidepressants. Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes https://www.jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 11 November 2022
  11. Hot Flashes: Diagnosis & Treatment – Treatment: Antidepressants. 20 May 2022. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 11 November 2022
  12. Hot Flashes: Diagnosis & Treatment – Treatment: Antidepressants. 20 May 2022. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 11 November 2022
  13. Hot Flashes: Diagnosis & Treatment – Treatment: Antidepressants. 20 May 2022. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795 Accessed: 11 November 2022
  14. Menopause Management Options: Natural Therapies (Complementary Medicine and Therapies). Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes https://www.jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 11 November 2022
  15. Menopause: Diagnosis and Management – Information for the Public: Managing Your Symptoms – Hot Flushes and Night Sweats. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Managing-your-symptoms Accessed: 11 November 2022
  16. Menopause: Diagnosis and Management – Information for the Public: Treating Menopausal Symptoms – Non-Prescribed Treatments: St John’s Wort. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Treating-menopausal-symptoms Accessed: 11 November 2022
  17. 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. 1. National Center for Complementary and Integrative Health https://www.nccih.nih.gov/health/tips/things-to-know-about-menopausal-symptoms-and-complementary-health-practices Accessed: 11 November 2022
  18. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:3-4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 11 November 2022
  19. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 11 November 2022
  20. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:3-4. https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 11 November 2022
  21. Hot Flashes: What Can I Do? Treating Menopause Symptoms: What’s Right for Me? Content Reviewed: 30 September 2021. National Institute on Aging https://www.nia.nih.gov/health/hot-flashes-what-can-i-do Accessed: 11 November 2022
  22. 4 Things To Know About Menopausal Symptoms and Complementary Health Practices. National Center for Complementary and Integrative Health https://www.nccih.nih.gov/health/tips/things-to-know-about-menopausal-symptoms-and-complementary-health-practices Accessed: 11 November 2022
Topic Last Updated: 11 November 2022 – Topic Last Reviewed: 11 November 2022

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