Oftentimes we have patients complaining about hot flashes or night sweats. About 80% of women will have some degree of these symptoms as they enter menopause. Those who enter surgical menopause (by having both ovaries removed in their pre-menopausal years) have the most dramatic onset of symptoms. Hormone replacement therapy (available in a wide variety of forms) has gotten a bad rap over the last decade, but in reasonably low doses used short term, it is still a very effective and safe option for many patients. http://www.menopause.org/for-women/menopauseflashes/the-experts-do-agree-about-hormone-therapy
For those patients who are unable or unwilling to use hormone replacement, there are also a number of alternative behavioral, nutritional and pharmeceutical options as well. For patients with mild to moderate symptoms, we often start simply by recommending dressing in layers in natural fibers, using fans at home and work, avoiding alcohol and spicy foods, etc. Aerobic exercise on a regular basis also has been shown to reduce hot flashes. Soy supplements contain plant estrogens and can be helpful. Estroven is one such supplement, although drinking soy milk or eating tofu or edamame can give you similar benefits. The benefit of black cohosh products is controversial, although I have had patients say Remifemin works for them. http://www.menopause.org/for-women/menopauseflashes/the-experts-do-agree-about-hormone-therapy
I have also had patients do well with accupuncture in some cases as well. Many patients find relief on an antihypertensive medication called Clonidine (aka Catapress). It is usually given once a day in a 0.1mg dose. It can also be given as a patch. There are a number of antidepressant medications that have been shown to have benefit for patients with hot flashes including Effexor and Pristiq. Gabapentin has also been shown to help reduce symptoms, although it usually has to be given 2 or 3 times a day. Most patient's symptoms will reduce spontaneously without treatment within a year, and those using hormone therapy are generally recommended not to stop treament "cold turkey" but rather to do a gradual wean in order to prevent recurrent symptoms.
For those patients who are unable or unwilling to use hormone replacement, there are also a number of alternative behavioral, nutritional and pharmeceutical options as well. For patients with mild to moderate symptoms, we often start simply by recommending dressing in layers in natural fibers, using fans at home and work, avoiding alcohol and spicy foods, etc. Aerobic exercise on a regular basis also has been shown to reduce hot flashes. Soy supplements contain plant estrogens and can be helpful. Estroven is one such supplement, although drinking soy milk or eating tofu or edamame can give you similar benefits. The benefit of black cohosh products is controversial, although I have had patients say Remifemin works for them. http://www.menopause.org/for-women/menopauseflashes/the-experts-do-agree-about-hormone-therapy
I have also had patients do well with accupuncture in some cases as well. Many patients find relief on an antihypertensive medication called Clonidine (aka Catapress). It is usually given once a day in a 0.1mg dose. It can also be given as a patch. There are a number of antidepressant medications that have been shown to have benefit for patients with hot flashes including Effexor and Pristiq. Gabapentin has also been shown to help reduce symptoms, although it usually has to be given 2 or 3 times a day. Most patient's symptoms will reduce spontaneously without treatment within a year, and those using hormone therapy are generally recommended not to stop treament "cold turkey" but rather to do a gradual wean in order to prevent recurrent symptoms.
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