From the Guidelines
Treatment for hot flashes should prioritize non-hormonal options, such as SNRIs, SSRIs, gabapentin, lifestyle modifications, and environmental modifications, as recommended by the American Cancer Society and American Society of Clinical Oncology 1. The goal of treatment is to alleviate symptoms while minimizing risks and improving quality of life.
- Non-hormonal prescription medications, such as venlafaxine (75 mg daily) and gabapentin (300 mg daily), have been shown to be effective in reducing hot flashes 1.
- Lifestyle modifications, including avoiding triggers like spicy foods, alcohol, and caffeine, maintaining a cool environment, and practicing stress reduction techniques, can also help alleviate symptoms 1.
- Acupuncture and cognitive behavioral therapy (CBT) may also provide relief for some women 1.
- Hormone replacement therapy (HRT) may be considered for moderate to severe hot flashes, but its use should be individualized and carefully weighed against potential risks, particularly in breast cancer survivors 1. Key considerations in treatment choice include hot flash severity, other medical conditions, and personal preferences, with regular reassessment to adjust as needed.
- It is essential to note that systemic hormone therapy is rarely given to patients with breast cancer to control menopausal symptoms, and non-hormonal medications are preferred 1.
- The anticonvulsant gabapentin and the antihypertensive clonidine have also been used in clinical practice to reduce hot flashes 1.
From the Research
Treatment Options for Hot Flashes
- Hormonal replacement therapy (HRT) is a common treatment for hot flashes, as it helps to alleviate symptoms by replenishing estrogen levels 2, 3, 4.
- Selective serotonin and norepinephrine reuptake inhibitors can also be used to treat hot flashes, in addition to lifestyle modifications 2.
- Estrogen therapy, such as conjugated equine estrogen (CEE) and 17beta-estradiol, can be effective in reducing hot flashes, with comparable effects and short-term adverse effects 5.
- Non-hormonal treatments are also available for the management of hot flashes, although HRT remains the standard treatment 3.
Considerations for Treatment
- The use of HRT should be evaluated on a patient-by-patient basis, taking into account the potential risks and benefits, as well as the individual's medical history and lifestyle 3, 4.
- The duration of HRT use should be limited to the shortest time necessary to alleviate symptoms, with regular monitoring and assessment of the patient's condition 3, 4.
- Alternative treatments, such as lifestyle modifications and non-hormonal therapies, should be considered for patients who are unable or unwilling to use HRT 2, 3.
Efficacy of Treatment Options
- Studies have shown that HRT can be effective in reducing hot flashes, with significant improvements in symptoms compared to placebo 5, 6.
- The efficacy of different estrogen therapies, such as CEE and 17beta-estradiol, has been compared in clinical trials, with similar results and adverse effects 5.
- Non-hormonal treatments, such as selective serotonin and norepinephrine reuptake inhibitors, have also been shown to be effective in reducing hot flashes, although the evidence is limited 2.