Alternatives for treating hot flashes facts
Introduction to menopause and hot flashes
Women frequently ask what symptoms they can anticipate during menopause. In reality, each woman experiences menopause differently. Some women have changes in several areas of their lives. It is not always possible to tell if these changes are related to aging, menopause or both. While one woman is certain that insomnia is a menopause symptom for her, another feels joint aches are her primary menopause symptom. Doctors find it difficult to communicate to their patients about menopause and what could be a host of uncomfortable symptoms. For example, medical science cannot explain how declining hormone levels during menopause could cause joint pain.
Menopause is not an illness, but a natural transition when a woman's reproductive ability ends. Yet many of the menopausal symptoms may mimic signs caused by diseases. When do women undergoing menopause need treatment in the first place? The same pattern of hot flashes in two women can have a very different psychological impact. For one woman, they can greatly disturb her daily functioning, but for another, while another may hardly be bothered.
What are hot flashes?
Hot flashes are experienced by many women, but not all women undergoing menopause have this experience. A hot flash is a feeling of warmth that spreads over the body, but is often most strongly felt in the head and neck regions. Hot flashes may be accompanied by perspiration or flushing. On average, they usually last from 30 seconds to several minutes. Although the exact cause of hot flashes is not fully understood, they are thought to be due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels. What is known is they can vary in severity, frequency, and duration.
"About 70 percent of women experience hot flashes, but their underlying physiology isn't well understood," said Rebecca Thurston, an assistant professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh.
Sometimes hot flashes are accompanied by night sweats (episodes of drenching sweats at nighttime). This may lead to awakening and difficulty falling asleep again, resulting in unrefreshing sleep and daytime tiredness.
How are hot flashes usually treated?
Traditionally, hot flashes have been treated with oral (by mouth) or transdermal (patch) forms of estrogen. Hormone therapy (HT), also referred to as hormone replacement therapy (HRT) or postmenopausal hormone therapy (PHT), consists of estrogens or a combination of estrogens and progesterone (progestin). Oral and transdermal estrogen are available as estrogen alone or estrogen combined with progesterone. Whether oral or transdermal, all available prescription estrogen replacement medications are effective in reducing hot flash frequency and severity.
However, long-term studies (NIH-sponsored Women's Health Initiative, or WHI) of women receiving oral preparations of combined hormone therapy with both estrogen and progesterone were halted when it was discovered that these women had an increased risk for heart attack, stroke, and breast cancer when compared with women who did not receive HT. Later studies of women taking estrogen therapy alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer. Estrogen therapy alone, however, is associated with an increased risk of developing endometrial cancer (cancer of the lining of the uterus) in postmenopausal women who have not had their uterus surgically removed.
The decision in regard to starting or continuing hormone therapy, therefore, is a very individual choice in which the patient and doctor must take into account the inherent risks and treatment benefits, plus each woman's own medical history. It is currently recommended that if hormone therapy is used, it should be used at the smallest effective dose for the shortest possible time.
Which alternative prescription medications are effective in treating hot flash symptoms of menopause?
A few prescription medications, in addition to estrogen, can provide relief for hot flashes. While none of these drugs is as effective as estrogen, studies show that non-estrogen drugs may have up to 70% of the effectiveness of estrogen therapy when treating hot flashes.
Why are some doctors reluctant to recommend nonprescription therapies for menopause symptoms?
Nonprescription products such as herbal supplements are not controlled by the FDA because they are considered food supplements by law. Because they are not regulated like prescription medications, their ingredients and potency vary from manufacturer to manufacturer, and even from bottle to bottle from the same manufacturer. Also, careful testing and proof of safety is not required as it is with prescription medications. (The only way the FDA can recall a nonprescription product is by proving that it is dangerous.) Furthermore, there are so many nonprescription products available that a doctor cannot possibly know exactly what is in each preparation. Moreover, not one of these products has been scientifically proven to be safe or effective.
So, how well have the nonprescription alternatives to hormone therapy been tested? Not one study has adhered to all of the stringent requirements that are necessary for approval of prescription medicines.
What are hot flashes?
Hot flashes are experienced by many women, but not all women undergoing menopause have this experience. A hot flash is a feeling of warmth that spreads over the body, but is often most strongly felt in the head and neck regions. Hot flashes may be accompanied by perspiration or flushing. On average, they usually last from 30 seconds to several minutes. Although the exact cause of hot flashes is not fully understood, they are thought to be due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels. What is known is they can vary in severity, frequency, and duration.
"About 70 percent of women experience hot flashes, but their underlying physiology isn't well understood," said Rebecca Thurston, an assistant professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh.
Sometimes hot flashes are accompanied by night sweats (episodes of drenching sweats at nighttime). This may lead to awakening and difficulty falling asleep again, resulting in unrefreshing sleep and daytime tiredness.
How are hot flashes usually treated?
Traditionally, hot flashes have been treated with oral (by mouth) or transdermal (patch) forms of estrogen. Hormone therapy (HT), also referred to as hormone replacement therapy (HRT) or postmenopausal hormone therapy (PHT), consists of estrogens or a combination of estrogens and progesterone (progestin). Oral and transdermal estrogen are available as estrogen alone or estrogen combined with progesterone. Whether oral or transdermal, all available prescription estrogen replacement medications are effective in reducing hot flash frequency and severity.
However, long-term studies (NIH-sponsored Women's Health Initiative, or WHI) of women receiving oral preparations of combined hormone therapy with both estrogen and progesterone were halted when it was discovered that these women had an increased risk for heart attack, stroke, and breast cancer when compared with women who did not receive HT. Later studies of women taking estrogen therapy alone showed that estrogen was associated with an increased risk for stroke, but not for heart attack or breast cancer. Estrogen therapy alone, however, is associated with an increased risk of developing endometrial cancer (cancer of the lining of the uterus) in postmenopausal women who have not had their uterus surgically removed.
The decision in regard to starting or continuing hormone therapy, therefore, is a very individual choice in which the patient and doctor must take into account the inherent risks and treatment benefits, plus each woman's own medical history. It is currently recommended that if hormone therapy is used, it should be used at the smallest effective dose for the shortest possible time.
Which alternative prescription medications are effective in treating hot flash symptoms of menopause?
A few prescription medications, in addition to estrogen, can provide relief for hot flashes. While none of these drugs is as effective as estrogen, studies show that non-estrogen drugs may have up to 70% of the effectiveness of estrogen therapy when treating hot flashes.
Why are some doctors reluctant to recommend nonprescription therapies for menopause symptoms?
Nonprescription products such as herbal supplements are not controlled by the FDA because they are considered food supplements by law. Because they are not regulated like prescription medications, their ingredients and potency vary from manufacturer to manufacturer, and even from bottle to bottle from the same manufacturer. Also, careful testing and proof of safety is not required as it is with prescription medications. (The only way the FDA can recall a nonprescription product is by proving that it is dangerous.) Furthermore, there are so many nonprescription products available that a doctor cannot possibly know exactly what is in each preparation. Moreover, not one of these products has been scientifically proven to be safe or effective.
So, how well have the nonprescription alternatives to hormone therapy been tested? Not one study has adhered to all of the stringent requirements that are necessary for approval of prescription medicines.
Source: http://www.rxlist.com
"About 70 percent of women experience hot flashes, but their underlying physiology isn't well understood," said Rebecca Thurston, an assistant professor of psychiatry, psychology, and epidemiology at the University of Pittsburgh.
Sometimes hot flashes are accompanied by night sweats (episodes of drenching sweats at nighttime). This may lead to awakening and difficulty falling asleep again, resulting in unrefreshing sleep and daytime tiredness.
Source: http://www.rxlist.com
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