Non-Hormonal Interventions for Hot Flashes
A large number of menopausal women experience hot flashes.
Hot flashes may be precipitated by hot weather, caffeine, spicy foods, alcohol, and stress. Hot flashes are described as a sudden sensation of heat felt in the face, neck, and chest that spreads over the entire body. They are usually accompanied by profuse sweating, followed by a chill. The incidence is greatest in the first two postmenopausal years.
Night sweats are particularly disturbing for menopausal women. Night sweats alter sleep patterns, causing insomnia and irritability.
A number of non-hormonal remedies are available for the treatment of hot flashes. Some of these remedies (e.g., vitamin E, black cohosh, and soy products) are available over-the-counter but are not FDA-approved. Some prescription medications are used “off label” to help reduce hot flashes.
|Drug ||Dosage ||Side Effects |
|Evening Primrose Oil ||Variable ||Nausea, diarrhea, blood clots. Do not use if seizure history or on blood thinners. |
|Black cohosh ||20 mg twice a day ||Mild stomach upset. Safe up to 6 mos. |
|Soy (plant estrogen) ||Variable ||Appears safe if consumed in foods. |
|clonidine (Catapres) ||1 mg in a.m. and at bedtime (also in patch form) ||Dry mouth, drowsiness, fatigue, lowers blood pressure |
|fluoxetine (Prozac) ||20 mg in am ||Dry mouth, nausea, insomnia. |
|paroxetine (Paxil) ||20 mg at bedtime ||Fatigue, nausea. |
|venlafaxine (Effexor) ||37.5 mg to 75 mg a day ||Fatigue, nausea, headache, dry mouth. Elevated blood pressure (at high doses). |
|gabapentin (Neurontin) ||Up to 300 mg three times a day ||Fatigue, dizziness, nausea. |
|Pristiq (desvenlafaxine) ||50 mg once daily ||Fatigue, nausea, headache, elevated blood pressure |
Carroll DG. Nonhormonal Therapies for Hot Flashes in Menopause. Am Fam Physician. 2006;73(3):457-464 www.aafp.org. Accessed December 29, 2010.
Nelson HD, Vesco KK, Haney E, et al. Nonhormonal Therapies for Menopausal Hot Flashes.JAMA. 2006;295(17):2057-2071. www.jama.ama-assn.org Accessed December 29, 2010.
Tice JA, Grady D. Alternatives to Estrogen for Treatment of Hot Flashes. JAMA. 2006;295(17):2076-2078. www.jama.ama-assn.org Accessed December 29, 2010.
National Center for Complementary and Alternative Medicine. Menopausal Symptoms and CAM. nccam.nih.gov Accessed December 29, 2010.
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