In this Article

• Introduction to menopause and hot flashes
• What are hot flashes?
• How are hot flashed usually treated?
• Which alternative prescription medications are effective in treating hot flash symptoms of menopause?
• Why are some doctors reluctant to recommend nonprescription therapies for menopause symptoms?
• What alternative treatments for menopause have been scientifically studied?
• Alternatives for Treating Hot Flashes At A Glance
• Alternative Treatments for Hot Flashes Glossary
• Alternative Treatments for Hot Flashes Index

How are hot flashes usually treated?

Traditionally, hot flashes have been treated with either 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). Both oral and transdermal estrogen are available either as estrogen alone or estrogen combined with progesterone (see the Hormone Replacement Therapy article). All available prescription estrogen replacement medications, whether oral or transdermal, are effective in reducing the frequency of hot flashes and their severity. Generally, these medications decrease the frequency of hot flashes by about 80 to 90%.

However, long-term studies (the NIH-sponsored Women's Health Initiative, or WHI) of women receiving 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 decision in which the patient and doctor must take into account the inherent risks and benefits of the treatment along with 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.

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