Hot Flashes (cont.)
Bioidentical hormone therapy
There has been increasing interest in recent years in
the use of so-called "bioidentical" hormone therapy for perimenopausal women.
Bioidentical hormone preparations are medications that contain hormones that
have the same chemical formula as those made naturally in the body. The hormones
are created in a laboratory by altering compounds derived from
naturally-occurring plant products. Some of these so-called bioidentical hormone
preparations are U.S. FDA-approved and manufactured by drug companies, while
others are made at special pharmacies called compounding pharmacies, which make
the preparations on a case-by-case basis for each patient. These individual
preparations are not regulated by the FDA, because compounded products are not standardized.
Advocates of bioidentical hormone therapy argue that the products, applied as
creams or gels, are absorbed into the body in their active form without the need
for "first pass" metabolism in the liver, and that their use may avoid
potentially dangerous side effects of synthetic hormones used in conventional
hormone therapy. However, studies to establish the long-term safety and
effectiveness of these products have not been carried out.
Other drug treatments
- The selective serotonin reuptake inhibitor (SSRI) medications have been shown be effective in
reducing menopausal hot flashes. These drugs are generally used in the treatment
of depression and
anxiety as well as other conditions The SSRI
that has been tested most extensively in the treatment of hot flashes is
venlafaxine (Effexor), although other SSRI drugs may be effective as well.
- Clonidine (Catapres) is an anti-hypertensive drug that
can relieve hot flashes in some women. Clonidine is taken either by pill or skin
patch and decreases blood pressure. Side effects of clonidine can include
dry
mouth, constipation, drowsiness, or difficulty sleeping.
- Gabapentin (Neurontin), a drug primarily used for the treatment of
seizures,
has also been effective in treating hot flashes.
- Megestrol acetate (Megace) is a progestin that is sometimes prescribed over a
short-term to help relieve hot flashes, but this drug is not usually recommended
as a first-line treatment for hot flashes. Serious side effects can occur if the
medication is abruptly discontinued. Megestrol may have the side effect of
weight gain.
- Medroxyprogesterone acetate (Depo-Provera) is another progestin
drug and is administered by injection to treat hot flashes. It may lead to
weight gain as well as bone loss.
Next: Complementary and alternative treatments »
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