Treatments for Hot FlashesJan 23, 2014
About 85 percent of U.S. women have hot flashes in menopause. They’re terrible and you just want them to stop, so you finally decided to take something for them and night sweats – but what do you take? Dr. Kirtly Jones talks about hot flashes, why they happen, and what types of treatments are available to make them go away.
Dr. Kirtly Parker Jones: You've finally decided to take something for those hot flashes and night sweats. What do you take, something from your doctor or something from the health food store? What really works, and where do you put it? This is Dr. Kirtly Parker Jones from the Department of Obstetrics and Gynecology at University of Utah Healthcare, and this is The Scope.
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Dr. Kirtly Parker Jones: About 85% of women in the U.S. have hot flashes in menopause. About 15% of menopausal women seek help because they are miserable. Eight to twenty hot flashes a day, hot, red and sweaty, a public demonstration of your hormonal situation. Sleep disturbed nights lead to dysfunctional days. Over the counter health food store's herbs and creams are not likely to harm you. Anything you try is going to make hot flashes a little better through the powerful placebo effect, but scientific studies have not shown that Chinese herbs or other herbs, minerals or soy anything are much more effective than placebo. Placebo works, so you might want to give it a try.
Non-hormonal medications from your clinician. There are some medications for depression or neurological conditions that work better than placebo. They have some side effects, but if you have a contraindication to estrogen, blood clots, breast cancer or you just don't want to take estrogen, talk to you clinician about those options.
Estrogen is what the brain wants, it's what your body made and it's highly effective for hot flashes. It won't get rid of all of the hot flashes, but decreases the number and intensity by about 85%. You can take it by pill, by patch on your skin, by cream on your skin, by spray on your skin, by a sniff up your nose or put it in your vagina. All of these places absorb estrogen well and work. Oral is easy, but is associated with about 1 more blood clot per 1000 women per year than estrogen across the skin or some of those other places.
Bio identical or not? It depends on what you mean by bio identical. If you mean ground up ladies ovaries, we don't have that. If you mean it looks identical to the molecules in your ovaries then you can get that in a form that's tested in quality control by the FDA or you can get it made in your local pharmacy. You choose, but your insurance may pay for one and not the other and the local pharmacy product may not be quality controlled.
Don't forget the progesterone if you have a uterus. To protect against an abnormal build up of the uterine lining you need another hormone just like your body did prior to menopause. It is almost always oral, but is transdermal in a very few cases. It can be synthetic or bio identical, you choose. Choose wisely because there is a lot of hype and not a lot of truth about progesterones. The good news is oral progesterone in significant doses can also decrease hot flashes and promotes normal sleep. Don't worry and don't fret. If you have a lot of hot flashes there is help out there. This is Dr. Kirtly Jones, and this is The Scope.
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