1. Take the Menopause Quiz
2. Menopause and Perimenopause Slideshow
3. Osteoporosis Slideshow Pictures

Medical Author:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

View Full Profile

Medical Editor:

William C. Shiel Jr., MD, FACP, FACR

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

View Full Profile

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
• Patient Comments: Hot Flashes of Menopause - Treatment
• Patient Comments: Alternative Treatments For Hot Flashes - Experience
• Patient Comments: Alternative Treatments for Hot Flashes - Treatments
• Find a local Obstetrician-Gynecologist in your town
• Alternative Treatments for Hot Flashes Index

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. Whether oral or transdermal, all available prescription estrogen replacement medications 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 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 one 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.