Hot flashes are one of the most common and distressing symptoms associated with menopause, occurring in more than 75% of postmenopausal women. They are especially problematic in
breast cancer patients since some
breast cancer therapies can induce
hot flashes. For mild
hot flashes, it is proposed that behavioral modifications are the first step in management. Hormonal
therapies, including
estrogens and
progestogens, are the most well known effective agents in relieving
hot flashes; however, the safety of these agents is controversial. There is an increasing amount of literature on nonhormonal agents for the treatment of
hot flashes. The most promising data regard newer
antidepressant agents such as
venlafaxine, which reduces
hot flashes by about 60%.
Gabapentin is another nonhormonal agent that is effective in reducing
hot flashes. While many complimentary
therapies, including
phytoestrogens, black cohosh, and
dehydroepiandrosterone, have been explored for the treatment of
hot flashes; none can be recommended at this time. Furthermore, there is a lack of strong evidence to support exercise, yoga, or relaxation for the treatment of
hot flashes. Paced respirations and
hypnosis appear to be promising enough to warrant further investigation. Another promising nonpharmacological
therapy, currently under investigation, involves a stellate ganglion block.