Menopause Menopause Basics

Beating the Heat: New Treatments for Hot Flashes

Medically Reviewed On: September 25, 2004

By Peggy Crane

Being hot, hot, hot may be all the rage on fashion runways, but hot flashes are anything but cool. A common symptom of menopause, they're uncomfortable, embarrassing, and highly disruptive to a woman's life at work and at play. Women undergoing some treatments for cancer, too, often suffer from hot flashes. A sharp decline in estrogen levels-sometimes caused by medications or surgical removal of the ovaries-is responsible for this distressing symptom in both groups of women. However, because estrogen is known to stimulate the growth of some breast cancer cells, replacing the declining hormone is not an option for women with this disease.

Hormone replacement therapy (HRT), a combination of estrogen and progesterone, has recently fallen out of favor as a long-term solution for the prevention of heart disease and osteoporosis in women, but it still can be used for short-term menopausal symptom relief in women who are cancer-free. Even so, women and their physicians have tended to proceed with caution, weighing the risks and benefits of the controversial therapy before making important treatment decisions.

Charles Loprinzi, MD, Chair of the Department of Medical Oncology at the Mayo Clinic in Rochester, Minnesota, is a leading researcher and clinician who has been investigating treatments for hot flashes for more than 15 years. In the following discussion, he shares what's new, what's working, what's hot and what's not. His recommendations are equally relevant for women whose hot flashes are a consequence of menopause and those whose symptoms stem from cancer therapy.

Are hot flashes natural?
They're a common symptom for many women as they reach menopause, which makes them seem "natural." As estrogen levels drop, a woman's blood vessels may expand rapidly, causing her skin temperature to rise. They're especially prevalent, by the way, in breast cancer survivors. We actually create hot flashes in these women when we treat them with tamoxifen, a type of hormonal cancer therapy. Chemotherapy puts premenopausal women into an abrupt menopause, which causes hot flash troubles that aren't "natural" at all.

How serious are hot flashes?
They're not dangerous, but they can be extremely disruptive. A woman can get a flushing episode at a business meeting. She may start sweating right in the middle of a personal interaction and have to remove her coat or sweater. Night sweats are a bigger problem. Women wake up wet. Their bedclothes are wet. Sometimes they have to get up and towel off, and then they can't get back to sleep. If this happens two or three times, they become very tired and can't respond well to daytime challenges because they're sleep deprived.

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