Managing Hot Flushes In Menopausal Women: A Review

Abstract

Hot flushes during menopause are distressing for women and result in poor quality of life. Purpose of the current review was to evaluate the available treatment modalities that should be utilised for the management of hot flushes. Menopause refers to last menses of women life and can be declared after amenorrhea of 12 months. Vasomotor symptoms including hot flushes and night sweats are common after menopause, affecting almost 50 - 85% women older than 45 years. The mean increment in core body and skin temperature is 0.5°C and 0.25 - 3°C during a hot flush attack. Low level of estrogen during menopause and its association in triggering episodes of hot flushes, is still under debate. The most accepted hypothesis is a narrowing of the thermoneutral zone (TNZ) triggered by estrogen fluctuations. Although, hormone replacement therapy (HRT) remains the standard treatment for the alleviation of such symptoms, incidence of life threatening side effects restrained medical professionals from its use. Complications associated with the use of HRT can be avoided by appropriate evaluation of patients before initiating therapy. Several guidelines have also recommended HRT (estrogen and progesterone) to be safe for up to a period of seven years. Both hormonal and non-hormonal treatments are used for the management of hot flushes. Since hot flushes are the least appreciated and neglected complication of menopause, current review provides detailed information on its background, pathophysiology and management, and emphasises the need of its treatment.

Attitude, Practices, and Barriers to Menopausal Hormone Therapy Among Physicians in Saudi Arabia

“…Additionally, it is proven that HRT is an effective treatment for hot flashes, yet its utilization is constrained by lack of understanding of therapy risks and benefits [22]. However, the preferred approach selected by 32.6% of the participants, for addressing hot flushes in our study was overwhelmingly centred around lifestyle modifications, where lifestyle modifications, encompassing strategies such as obesity management, exercise, smoking cessation, relaxation techniques, and acupuncture, have demonstrated promise in effectively managing hot flashes [23].…”

Evaluation and Comparison of Citalopram and Venlafaxine for Management of Hot Flashes in Women with Breast Cancer

“…However, associated complications including dry mouth, fatigue, and hypotension, made it's prescription a challenge. Some clinical trials introduce other agents, including gabapentin and pregabalin, which brought on beneficial effects in patients with hot flashes [14][15][16]. Currently, the second generation of antidepressants, including SSRIs and SNRIs such as citalopram and venlafaxine, have shown remarkable efficacy in reducing vasomotor complications.…”

Effect of estradiol replacement on hippocampal concentrations of estrogens in aged rhesus macaques maintained on an obesogenic diet

“…Menopause is associated with a marked decrease in circulating concentrations of estrogens, which in turn contributes to the etiology of several age-associated disorders, including hot flushes [ 1 , 2 ], decreased bone mineral density [ 3 , 4 ], cognitive decline [ [5] , [6] , [7] , [8] , [9] ], increased risk of cardiovascular disease [ 10 , 11 ] and attenuated immune function [ 12 , 13 ]. Consequently, estrogen + progestin hormone replacement therapy (HRT) in postmenopausal women, and estrogen replacement therapy (ERT) in women that have had their ovaries surgically removed represent effective interventions [ 14 , 15 ].…”