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PubMed2004

Pilot study using gabapentin for tamoxifen-induced hot flashes in women with breast cancer.

In this pilot study, 22 women with breast cancer on tamoxifen therapy with at least two hot flashes a day took oral gabapentin at 300 mg three times a day for 4 weeks. The 16 women who completed the study had a mean decrease in hot flash duration of 73.6% (P = 0.027), frequency of 44.2% (P < 0.001), and severity of 52.6% (P < 0.001), with a complete response in 8/16 women. Side effects reported by four women who did not complete 4 weeks of the study were nausea (1/4), rash (1/4) and excessive sleepiness (3/4). Two additional patients did not provide complete data. Gabapentin is a promising new agent in the treatment of tamoxifen induced hot flashes, and should be studied further.

Acetates↗
PubMed1988

Pathological hyperprolactinemia suppresses hot flashes in menopausal women.

Hyperprolactinemia impairs pituitary-gonadal function in young women, but its effect in menopausal women is not known. The purpose of this report is to describe the effect of hyperprolactinemia on gonadotropin secretion and hot flashes in menopausal women before and after treatment with a dopamine agonist. We studied two such women with prolactinomas. Both had plasma LH and FSH levels in the range found in premenopausal women and no hot flashes. Treatment with bromocriptine was associated with normalization of plasma PRL levels, elevation of plasma gonadotropin levels, and the onset of menopausal hot flashes in both patients. We conclude that hyperprolactinemia can inhibit the augmented gonadotropin secretion that occurs in postmenopausal women and prevent hot flashes.

Adenoma↗
PubMed2005

A behavioral group treatment program for menopausal hot flashes: results of a pilot study.

In the present study, we tested the effectiveness of a cognitive-behavioral group treatment (CBGT) for hot flashes in menopausal women. Treatment was administered over 8, 90 min weekly sessions and consisted of education, relaxation training and cognitive restructuring. Nineteen women meeting STRAW staging criteria for the menopause transition (stages -1 to +1) were randomly assigned to immediate or delayed treatment (wait list) and were asked to monitor their hot flashes and night sweats prospectively. They also completed questionnaires, including the Women's Health Questionnaire and the Menopause Specific Quality of Life Questionnaire to determine psychosocial benefits of treatment. Results suggested that the CBGT was moderately successful in reducing the frequency of total vasomotor symptoms [F (1, 17) = 6.16, p < .01], as measured by daily symptom diaries. While there were arithmetic improvements in psychosocial functioning in this sample, these results were not significant. Despite the limitations of small sample size and possible placebo effect, this pilot study supports the notion that cognitive-behavioral interventions aimed at reducing vasomotor symptoms may be of value for menopausal hot flashes when administered in a small-group format.

Cognitive Behavioral Therapy↗
PubMed2006

Adjuvant chemotherapy followed by goserelin compared with either modality alone: the impact on amenorrhea, hot flashes, and quality of life in premenopausal patients--the International Breast Cancer Study Group Trial VIII.

PURPOSE: The purpose of this article is to compare quality of life (QOL) and menopausal symptoms among premenopausal patients with lymph node-negative breast cancer receiving chemotherapy, goserelin, or their sequential combination, and to investigate differential effects by age. PATIENTS AND METHODS: We evaluated QOL data from 874 pre- and perimenopausal women with lymph node-negative breast cancer who were randomly assigned to receive six courses of classical cyclophosphamide, methotrexate, and fluorouracil (CMF) chemotherapy, ovarian suppression with goserelin for 24 months, or six courses of classical CMF followed by 18 months of goserelin. We report QOL data collected during 3 years after random assignment in patients without disease recurrence. RESULTS: Overall, patients receiving goserelin alone showed a marked improvement or less deterioration in QOL measures over the first 6 months than those patients treated with CMF. There were no differences at 3 years after random assignment according to treatment except for hot flashes. As reflected in the hot flashes scores, patients in all three treatment groups experienced induced amenorrhea, but the onset of ovarian function suppression was slightly delayed for patients receiving chemotherapy. Younger patients (< 40 years) who received goserelin alone returned to their premenopausal status at 6 months after the cessation of therapy, while those who received CMF showed marginal changes from their baseline hot flashes scores. CONCLUSION: Age-adjusted risk profiles that consider patient-reported outcomes enable patients to adapt to their disease and treatment, such as considering the trade-offs between delayed endocrine symptoms, but higher risk of permanent menopause with chemotherapy, and immediate but reversible endocrine symptoms with goserelin, in younger premenopausal patients.

Adult↗
PubMed2004

Commonly used types of postmenopausal estrogen for treatment of hot flashes: scientific review.

CONTEXT: Recommendations for postmenopausal hormone therapy have changed since the Women's Health Initiative indicated that estrogen was harmful for use in disease prevention; however, treatment of menopausal symptoms with low-dose estrogen remains an approved indication for use. OBJECTIVE: To compare the short-term efficacy and adverse effects of 2 commonly used estrogens, conjugated equine estrogen (CEE) and 17beta-estradiol, for reducing menopausal hot flashes by systematically reviewing randomized controlled trials. DATA SOURCES: MEDLINE, EMBASE, the Cochrane Database of Systematic Reviews, and Cochrane Controlled Trials Registry were searched from the database start dates to July 2003 using database-specific key words. Reference lists of published articles, experts, and pharmaceutical manufacturers were also consulted. STUDY SELECTION: English-language abstracts of double-blind, randomized, placebo-controlled trials and systematic evidence reviews of oral CEE and oral and transdermal 17beta-estradiol, and treatment of menopausal hot flashes and their adverse effects. DATA EXTRACTION: Study design, population characteristics, eligibility criteria, interventions, withdrawals, adverse effects, and results for each outcome. Study quality was assessed using predefined criteria based on parameters developed with the US Preventive Services Task Force and the UK National Health Services Centre. DATA SYNTHESIS: A total of 32 trials including 4 head-to-head comparisons met inclusion criteria; 14 trials met criteria for meta-analysis. All estrogen agents significantly reduced the weekly number of hot flashes compared with placebo (CEE, 1 trial: mean change, -19.1; 95% confidence interval [CI], -33.0 to -5.1; oral 17beta-estradiol, 5 trials: pooled weighted mean difference, -16.8; 95% CI, -23.4 to -10.2; transdermal 17beta-estradiol, 6 trials: pooled weighted mean difference, -22.4; 95% CI, -35.9 to -10.4); differences between agents were not significant. Breast tenderness and atypical vaginal bleeding were the most frequently reported adverse effects among estrogen users. The influence of progestin or progesterone use, cyclic and continuous regimens, and differences in adverse effects could not be determined. CONCLUSION: Conjugated equine estrogen and 17beta-estradiol have consistent and comparable effects on treatment of menopausal hot flashes and may have similar short-term adverse effects.

Estradiol↗
PubMed1997

The perimenopausal hot flash: epidemiology, physiology, and treatment.

The "hot flash" (HF), or vasomotor instability, is experienced by 75% of perimenopausal and menopausal women in the United States. The experience for some women is a minor annoyance but for others, the HF is an intensely unpleasant sensation that is disruptive to their lives. The HF is thought to be triggered by a number of external and internal stimuli such as anxiety, stress, ambient high temperatures, caffeine, and alcohol. The thinner woman tends to experience more severe and frequent HFs than the woman with more adipose tissue, probably because of the ability of adipose tissue to transform androstenedione to estrone and estradiol. Smoking history also tends to be associated with the experience of HFs at an earlier age. The etiology of HFs in the decreasing estrogen state is related to the downward resetting of the hypothalamic thermoregulating mechanism, probably by the action of norepinephrine, which is usually modulated by estrogen. The body attempts to dissipate unwanted body heat by vasodilation, thus causing the sensation of the HF. The most successful treatment modalities have been hormone replacement therapy with estrogen and progesterone. Alpha 2-adrenergic blockers have also shown some limited effectiveness. Many alternative therapies such as vitamin E, primrose oil, dong quai, and black cohash have anecdotal support but have not been thoroughly studied. Relaxation, exercise, avoidance of triggering factors, and control of external environment have all been utilized with some success by women.

Adaptation, Psychological↗
PubMed1998

Menopausal-like hot flashes reported in women of reproductive age.

OBJECTIVE: To report the occurrence of menopausal-like hot flashes in women of reproductive age (18-45 years). DESIGN: Observational, prospective cohort study with a retrospective survey component. SETTING: Tertiary care premenstrual syndrome (PMS) clinic and university campus. PATIENT(S): Patients with confirmed PMS (n = 157) were compared with those with chronic menstrual cycle-related symptoms (n = 27). Women without menstrual cycle-related symptoms were solicited as controls (n = 58). INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The frequency of episodes of chills and sweats and the magnitude of menstrual cycle-related symptoms were recorded over one cycle using the Prospective Record of the Impact and Severity of Menstrual Symptomatology (PRISM) Calendar. Characteristics of the episodes of chills and sweats were ascertained by a retrospective questionnaire. RESULT(S): In each group, the frequency of episodes of chills and sweats closely patterned the mean daily PRISM Calendar scores. At least one episode of chills and sweats was reported by 83.4% of the PMS group and 81.5% of the chronic group compared with 43.1% of the control group. The mean (+/-SD) number of episodes per cycle was 5.6 +/- 4.9 for the PMS group and 9.5 +/- 9.1 for the chronic group compared with 1.2 +/- 2.0 for the control group (the difference between all means was statistically significant). CONCLUSION(S): Episodes of chills and sweats similar to menopausal hot flashes were commonly reported by women with cyclic and chronic menstrual cycle-related symptoms.

Adolescent↗
PubMed1979

Elevations in skin temperature of the finger as an objective index of postmenopausal hot flashes: standardization of the technique.

The present study was designed to validate and standardize a technique of continuous recording of skin temperature of the finger as an objective index of hot flashes. Significant skin temperature rises (greater than 1 degree C) were recorded in close temporal relationship to 69% of subjective hot flashes experienced by seven postmenopausal women. The temperature elevations occurred at an interval of 54 +/- 10 minutes (mean +/- standard error) and lasted an average of 31 minutes. The mean increase was 2.7 degrees +/- 0.2 degrees C. The extent of the temperature elevations found in the postmenopausal subjects was significantly greater than in premenopausal control subjects (P less than 0.05) and was reduced by estrogen treatment (P less than 0.02). This study substantiates that the recording of skin temperature changes of the finger provides an objective index of hot flashes. This should assist in the investigation of the underlying disturbance and provide more accurate evaluation of modes of therapy.

Adult↗
PubMed1981

Thyrotropin-releasing hormone and the menopausal hot flash.

The possibility that the sudden discharge of thyrotropin-releasing hormone (TRH) in the brain triggers the climacteric hot flash was tested (double-blind) by an intra-venous, bolus injection of 500 microgram of TRH into 7 post-menopausal women and 1 menstruating control. Temperatures and sweating were recorded continuously on the recumbent subject during the 2-h test. None of the women reacted either subjectively or objectively to the placebo. TRH induced gastric pain in 1 post-menopausal subject. In another subject TRH elicited no response during the first test, but a week later in a second test it evoked transient nausea and a series of hot flashes with bursts of sweating. Published results of animal studies suggest that a higher dose of TRH would probably stimulate hot flash-like responses in more women.

Adult↗
PubMed2005

Hot flashes are associated with psychological symptoms of anxiety and depression in peri- and post- but not premenopausal women.

OBJECTIVE: To explore the relationship between anxiety, depression, vasomotor symptoms, and menopausal status among middle-aged women. DESIGN: A population-based study involving a rural Taiwanese population. Participants received a structured questionnaire, which included the hospital anxiety and depression scale (HADS), gynecological history and a checklist of menopausal symptoms in the most recent 2 weeks. RESULTS: A total of 1273 women with no history of surgical menopause and hormonal therapy history participated. The mean anxiety, depression, and total HADS scores were 4.3 +/- 3.3, 3.3 +/- 2.8 and 7.6 +/- 5.3, respectively, and did not differ according to menopausal status. A total of 10.5% participants reported hot flashes within the previous 2 weeks. After controlling for educational status and insomnia, anxiety (6.0 +/- 3.8 versus 4.1 +/- 3.1) and depression scores (4.0 +/- 3.3 versus 3.2 +/- 2.7) were significantly higher (p < 0.001) compared with those without hot flashes. These differences were attributed to peri- and postmenopausal subjects. CONCLUSIONS: Hot flashes in peri- and postmenopausal women were associated with anxious and depressive symptoms in East Asian population with low prevalence of vasomotor symptoms.

Adult↗
PubMed1988

Hot flash epilepsy.

A woman had episodes of bilateral thermal sensation, initially thought to be hot flashes related to menopause. EEG telemetry documented the epileptic nature of the attacks with an electrographic seizure emanating from the right temporal area coincident with the hot flashes.

Adult↗
PubMed2005

[Prevalence and factors associated with hot flashes in climacteric and post-climacteric women].

A cross-sectional study was conducted on the prevalence of hot flashes and associated factors among women from 40 to 69 years old, from a population-based sample in the city of Pelotas, southern Brazil. A multi-stage sampling process was used, and data were collected through an interview and a self-applied questionnaire. A total of 879 women were included. Point prevalence and lifetime prevalence were 30.1% and 53.2%, respectively. Factors associated with hot flashes were: pre-menopausal status (RP = 2.33) and post-menopausal status (RP = 2.66); age 45-49 years (RP = 1.34) and 50-54 years (RP = 1.42); lower social class (RP = 2.16); no use of a hormonal contraception method after 40 years of age (RP = 1.40); obesity (RP = 1.39) and overweight (RP = 1.32); and not having a partner (RP = 0.80). High prevalence of this symptom indicates that health facilities should be prepared to deal with problems encountered by climacteric women.

Adult↗
PubMed2004

Tubal sterilization and hot flashes.

A cross-sectional study was conducted among women ages 40-60 years to assess the association between tubal sterilization and the occurrence of any, moderate/severe, or daily hot flashes. Although women with tubal sterilization were more likely to report hot flashes than were nonsterilized women, this association was largely due to differences in characteristics between the women, particularly body mass.

Adult↗
PubMed2005

The potential of 5-hydryoxytryptophan for hot flash reduction: a hypothesis.

Hormone replacement therapy (HRT) is contraindicated in women with a history of breast cancer or a high risk of breast cancer development. Recent results from large clinical trials, such as the Women's Health Initiative, have demonstrated increased risks of thromboembolic events and a moderate increased risk of breast cancer in women using conjugated estrogens and progestogens. There is a need for viable non-hormonal alternative treatments to HRT, such as nutritional and botanical therapies, in this population of women, who tend to experience more significant vasomotor symptoms. Safe and effective therapies that do not stimulate breast cell proliferation could prove extremely useful for the management of such symptoms for women in both low- and high-risk breast cancer populations. As a non-hormonal treatment, anti-depressants, such as selective serotonin reuptake inhibitors (SSRIs), have been shown to improve hot flash symptoms in women. The proposed mechanism is related to an increase in serotonin allowing for an increase in the set point of the brain's thermoregulator. In small clinical studies, the administration of tryptophan and 5-hydroxytryptophan (5HTP), the precursors of serotonin, have been shown to reduce depressive symptoms, possibly by enhancing the synthesis of serotonin. Thus, increased serotonin levels may have the ability to decrease hot flashes in a mechanism similar to that of SSRIs without the risks of breast cell stimulation. This would be particularly desirable for menopausal women with breast cancer or with risks of breast cancer. This article discusses the background information on hot flashes, SSRIs, tryptophan, and 5HTP, and possible clinical application of 5HTP for menopausal women with breast cancer risk.

5-Hydroxytryptophan↗
PubMed2006

Pilot evaluation of selective serotonin reuptake inhibitor antidepressants in hot flash patients under androgen-deprivation therapy for prostate cancer.

PURPOSE: Hot flash (HF) is a common side effect in prostate cancer patient undergoing androgen-deprivation therapy (ADT). In this study, we evaluated the efficacy of paroxetine (selective serotonin reuptake inhibitors (SSRIs)) for HF. PATIENTS AND METHODS: In total, 10 men with prostate cancer under ADH who were suffering with HF entered this study. Self-report questionnaire was used for the evaluation. RESULTS: The average rating for HF frequency decreased (P=0.009) and HF severity decreased (P=0.0332) also, reported QOL score increased (P=0.0218). CONCLUSION: These preliminary data suggest that low dose (10 mg/day) of antidepressant paroxetine can be helpful in the treatment of HFs in patients under ADT for prostate cancer. Further controlled studies are needed to more fully evaluate the efficacy of the SSRIs.

Aged↗
PubMed1996

[Hot flashes and hormonal treatment of prostate cancer].

Androgen suppression in the context of the treatment of prostatic cancer is responsible for hot flashes in 75% of patients, which alter the quality of life to varying degrees depending on the patient. They constitute a source of major discomfort in 30 to 40% of patients. The pathophysiology of this effect is now known and involves: sex steroids, central opiates and intrahypothalamic catecholamines. The incidence of hot flashes appears to vary according to the type of hormonal treatment administered. The various treatments available are not equally effective. Non-hormonal treatments are of little value. Hormonal treatments: oestrogens and steroidal antiandrogens are the most effective. Progestogens also appear to be just as effective or even more effective than these other agents, with negligible adverse effects at the doses used in this indication.

Androgen Antagonists↗
PubMed1983

Multiple component self-control program for menopausal hot flashes.

Four menopausal women served as their own controls in a study of the application of behavioral methods to the treatment of hot flashes. After a 3-or 4-week baseline period, they received 10 sessions of training in a variety of stress and temperature control techniques, including relaxation, self-suggestions of cool thoughts and images, marital contingency contracting and temperature feedback. The percentage reductions in number of flashes between the last 2 weeks of baseline and the last 2 weeks of training were 41, 75, 76 and 90 for the 4 participants. Treatment gains were maintained at 6-months follow-up. These substantial reductions in frequency of hot flashes offer strong support for the further investigation of the use of behavioral methods as alternatives or additions to medicative therapies.

Adult↗
PubMed1982

Ethnography of the menopause-related hot flash.

Research was conducted to learn how women of two ethnic groups in the United States experience and describe menopause-related hot flashes, their reports of associated events and activities, and the ways in which they cope with the occurrence of the flashes. The women's cognitive ordering of events was learned through ethnographic inquiry, using questions which were derived from respondent-generated topics. Descriptions and responses to this physiological event were similar, but interpretation differed. Middle-class Anglo American women spoke of the sensations negatively, but for Mexican American women, the menopausal hot flash had positive components of meaning.

Adult↗