Hot Flashes (cont.)

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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.
Medically Reviewed by a Doctor on 1/7/2014

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