Lynn* came to see me with severe hot flashes and night sweats. She worked in sales and had resorted to bringing extra blouses in her car because she inevitably sweated through at least one each day. She was beyond irritable and hadn’t slept through the night in months. “I feel like a different person,” she said. “I can’t live like this.” Lynn wanted to know about all of her options for treatment.
Herbs, Soy and Acupuncture
I began by explaining how yoga, acupuncture and deep breathing had been shown to be effective, then moved into the research on black cohosh and soy. She wasn’t interested in hormones, but did want to discuss other prescription remedies. She had tried increasing her soy already and wanted something more effective than the herbs and yoga breathing we discussed.
Though only one anti-depressant has been approved by the FDA as a treatment for hot flashes, there’s a growing body of evidence that all of them work. Many of my patients do very well on anti-depressants and find relief from hot flashes. Lynn decided to try it for a few weeks to see if it helped. We believe that they help re-set our thermostats, decreasing the likelihood of sweating from small changes in temperature and from stress hormones.
Within a few days, she saw a reduction in her hot flashes and night sweats. They reduced to about 1-2 day and were much more manageable. Her sleep had improved dramatically. “I’m so much better than I was,” she said, “I’m not 100%, but I feel like I can deal with these few hot flashes now.” Lynn’s experience is typical for my other patients. They find improved sleep and fewer symptoms. I also have patients with breast cancer, who are experiencing hot flashes from tamoxifen use anti-depressants.
Paroxetine, Brisdelle – This is the first non-hormonal prescription medication that has been approved by the FDA to treat hot flashes and night sweats. The active medication, paroxetine has been used in higher doses to treat depression and OCD. In the lower doses, menopausal women found relief. We believe that paroxetine may help reset a woman’s thermostat so that she can remain cooler.
Though there is no FDA approval for the use of Gabapentin for hot flashes and night sweats, nevertheless, many women with breast cancer have been getting relief at night from using this medication. Gabapentin causes drowsiness in addition to helping re-set the thermostat.
For more tips, please check out my new book, The Hot Guide to a Cool Sexy Menopause. It’s available on Amazon, Barnes and Noble, for E-readers, wherever books are sold and through Basic Health Publishing.
Disclosures: * Names are changed. I have no financial relationships to disclose.