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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.

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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.

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In this Article

• What are hot flashes?
• What causes hot flashes?
• What are the symptoms of hot flashes?
• How are hot flashes diagnosed?
• What is the treatment for hot flashes?
• Hormone therapy
• Bioidentical hormone therapy
• Other drug treatments
• Complementary and alternative treatments
• Phytoestrogens
• Black cohosh
• Other alternative therapies
• Can hot flashes be prevented?
• Hot Flashes At A Glance
• Patient Comments: Hot Flashes - Describe Your Experience
• Patient Comments: Hot Flashes - Causes
• Patient Comments: Hot Flashes - Treatments
• Find a local Endocrinologist in your town
• Hot Flashes Index

There are a variety of treatments for hot flashes such as:

• hormone therapy,
  
  
• bioidentical hormone therapy,
  
  
• other drug treatments,
  
  
• complementary and alternative treatments,
  
  
• phytoestrogens,
  
  
• black cohosh, and
  
  
• other alternative therapies.

Some of these have not been proven by clinical studies, nor are they approved by the FDA.

Traditionally, hot flashes have been treated with either oral 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 alone or a combination of estrogens and progesterone (progestin). All available prescription estrogen medications, whether oral or transdermal; are effective in reducing the frequency of hot flashes and their severity. Research indicates that 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 hormone therapy. 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.

More recently, it has been noted that the negative effects associated with hormone therapy were described in older women who were years beyond menopause, and some researchers have suggested that these negative outcomes might be lessened or prevented if hormone therapy was given to younger women (prior to or around the age of menopause) instead of women years beyond menopause.

The decision in regard to starting or continuing hormone therapy, therefore, is an 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.