Health A-Z

Medical Content Created by the Faculty of the
Harvard Medical School

Hot Flashes

Treatment

Estrogen is the most effective medication available to relieve hot flashes. Short-term use of low-dose estrogen may be prescribed, with or without progesterone. If a woman still has her uterus, estrogen is prescribed together with progesterone to decrease the small risk of uterine cancer. Estrogen used alone causes growth of the uterine lining but adding progesterone prevents or decreases this growth, thereby decreasing the risk of developing uterine cancer. If your uterus was removed, then only estrogen is required.

Estrogen can be taken as a pill or administered through a skin patch or a vaginal ring. Progesterone can be taken as a pill or a patch or as a vaginal suppository. Women who use estrogen should use the smallest dose that relieves hot flashes.

Because of potential side effects and dangers of hormone therapy, many women choose not to use estrogen in any form. Until recently, estrogen had been thought to reduce the incidence of heart attack and stroke in postmenopausal women, but recent clinical trials, known as the Women's Health Initiative, have thrown doubt on that theory. This research shows that women actually may be more at risk of heart attack and stroke while using combined estrogen-progesterone therapy. Based on this study, the combined use of estrogen and progesterone is no longer recommended for the prevention of heart disease. Research on the effects of estrogen-only therapy is still in progress.

Alternative medications to help decrease the intensity of hot flashes include clonidine (Catapres), lofexidine (Britlofex), methyldopa (Aldomet), or antidepressants such as venlafaxine (Effexor), paroxetine (Paxil), fluoxetine (Prozac) and sertraline (Zoloft). For women who have undergone surgical menopause and have unusually severe hot flashes, some studies have shown that a combination of estrogen and androgen may be effective.

Several nonprescription herbal remedies have been proposed as natural ways to prevent or treat hot flashes. Many of these treatments have not been studied in large clinical trials. Although black cohosh has been previously promoted as a treatment for hot flashes, a study reported in the December 2006 Annals of Internal Medicine found that the root was no better than a placebo.

Estrogen is the most effective medication available to relieve hot flashes. Short-term use of low-dose estrogen may be prescribed, with or without progesterone. If a woman still has her uterus, estrogen is prescribed together with progesterone to decrease the small risk of uterine cancer. Estrogen used alone causes growth of the uterine lining but adding progesterone prevents or decreases this growth, thereby decreasing the risk of developing uterine cancer. If your uterus was removed, then only estrogen is required.

Estrogen can be taken as a pill or administered through a skin patch or a vaginal ring. Progesterone can be taken as a pill or a patch or as a vaginal suppository. Women who use estrogen should use the smallest dose that relieves hot flashes.

Because of potential side effects and dangers of hormone therapy, many women choose not to use estrogen in any form. Until recently, estrogen had been thought to reduce the incidence of heart attack and stroke in postmenopausal women, but recent clinical trials, known as the Women's Health Initiative, have thrown doubt on that theory. This research shows that women actually may be more at risk of heart attack and stroke while using combined estrogen-progesterone therapy. Based on this study, the combined use of estrogen and progesterone is no longer recommended for the prevention of heart disease. Research on the effects of estrogen-only therapy is still in progress.

Alternative medications to help decrease the intensity of hot flashes include clonidine (Catapres), lofexidine (Britlofex), methyldopa (Aldomet), or antidepressants such as venlafaxine (Effexor), paroxetine (Paxil), fluoxetine (Prozac) and sertraline (Zoloft). For women who have undergone surgical menopause and have unusually severe hot flashes, some studies have shown that a combination of estrogen and androgen may be effective.

Several nonprescription herbal remedies have been proposed as natural ways to prevent or treat hot flashes. Many of these treatments have not been studied in large clinical trials. Although black cohosh has been previously promoted as a treatment for hot flashes, a study reported in the December 2006 Annals of Internal Medicine found that the root was no better than a placebo.