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PubMed1985

Relationships among sexual behavior, hot flashes, and hormone levels in perimenopausal women.

Forty-three perimenopausal women kept daily records of menstrual cycles and sexual activity. Data on hot flashes and plasma estradiol and testosterone levels were obtained at two points during the menopausal transition. The prospective data yielded a significant negative association between hot flash ratings and regularity of sexual intercourse at both time points. A significant negative correlation was found between estradiol (in the early part of the cycle) and hot flashes ratings at the first data point only, and positive correlations were found between hot flashes and ratio of testosterone to estradiol (T/E) at both. Frequency of sexual intercourse and level of plasma estradiol were higher, and T/E and hot flash ratings were lower in "early" perimenopausal women who were still having cycles at least once every 30 days, as compared with "late" perimenopausal women who were cycling less often. It was concluded that a close association exists between increasing irregularity of menstrual cycles, hot flashes, declining estradiol levels, and declining frequency of intercourse during the perimenopause. Causal relationships remain to be established.

Adult↗

PubMed1994

Transdermal clonidine for ameliorating post-orchiectomy hot flashes.

To determine the efficacy of transdermal clonidine for alleviating post-orchiectomy hot flashes, a randomized, double-blind, crossover clinical trial was designed including 70 men with a history of prostate cancer who had undergone a medical or surgical orchiectomy and were suffering from hot flashes. The results of this study demonstrated that clonidine did not significantly decrease hot flash frequency or severity. Future research is necessary to find effective means of alleviating hot flashes in post-orchiectomy patients.

Adult↗

PubMed1990

Treatment of post-orchiectomy hot flashes with transdermal administration of clonidine.

The occurrence of hot flashes in men after bilateral orchiectomy for prostatic carcinoma can be bothersome and difficult to treat. Transdermal clonidine was administered to 7 patients with such symptoms. In 3 patients the hot flashes were ablated and in the remaining 4 the number and frequency of attacks were considerably reduced. No significant side effects were encountered. We suggest that transdermal clonidine (0.1 mg.) administered weekly can safely control undesirable hot flashes in men after bilateral orchiectomy.

Administration, Cutaneous↗

PubMed2005

Comparing the effects of estrogen and an herbal medicine on peripheral blood flow in post-menopausal women with hot flashes: hormone replacement therapy and gui-zhi-fu-ling-wan, a Kampo medicine.

We investigated the association between blood flow in the extremities and hot flashes, and compared change in blood flow following hormone replacement therapy (HRT) and Gui-zhi-fu-ling-wan (Keishi-bukuryo-gan), a herbal therapy in post-menopausal women with hot flashes. Three hundred and fifty-two post-menopausal women aged 46-58 years (mean: 53.4 +/- 3.6 years) with climacteric complaints participated in the study. One hundred and thirty-one patients with hot flashes were treated with HRT (64 cases) or herbal therapy (67 cases). Blood flow was measured with laser doppler fluxmetry under the jaw, in the middle finger and in the third toe. Post-menopausal women with hot flashes (129 cases) showed significantly higher blood flow under the jaw (13.6 +/- 4.13) than women without hot flashes (166 cases) (5.48 +/- 0.84) (p < 0.0001). Blood flow at this site decreased significantly with either therapy (p < 0.0001). On the other hand, the administration of Gui-zhi-fu-lingwan significantly increased (p = 0.002) the blood flow in the lower extremities, whereas HRT decreased the blood flow. Thus, we have demonstrated that Gui-zhi-fu-ling-wan did not affect the activity of vasodilator neuropeptides on sensory neurons of systemic peripheral vessels uniformly. Therefore, Gui-zhi-fu-ling-wan, rather than HRT, is suggested as an appropriate therapy for treatment of hot flashes in the face and upper body with concomitant coldness in the lower body, which is one of the symptoms of menopause.

Administration, Oral↗

PubMed2004

Management of hot flashes in breast cancer survivors and men with prostate cancer.

Hot flashes are a significant complaint among many breast cancer survivors and many men undergoing androgen deprivation therapy for prostate cancer. Several therapeutic approaches are available to the suffering man or woman. Many of these individuals have tried nonpharmacologic and nonconventional approaches. However, most nonpharmacologic treatments have not been compared with placebo or were not more effective than placebo in prospective, randomized clinical trials. The most effective nonhormonal treatments for hot flashes include agents from the selective serotonin or noradrenergic reuptake inhibitor (SSRI/SNRI) family. Paroxetine, 10 mg/d, or venlafaxine, 37.5 mg/d, are reasonable initial dosages, and if symptoms do not improve within a week or two, the dosage can be doubled. Gabapentin appears to provide similar benefits, but direct comparisons have not been reported. Because of the strong association between gonadal hormones and breast and prostate cancer, the use of hormonal agents to treat hot flashes in these patients has been limited. However, such hormonal therapies as depomedroxyprogesterone acetate can be prescribed for an informed individual who experiences bothersome symptoms despite nonhormonal treatments.

Amines↗

PubMed2006

Cortical activation during menopausal hot flashes.

OBJECTIVE: To determine regions of brain activation associated with menopausal hot flashes and sweating. DESIGN: Controlled laboratory study. SETTING: University medical center. PATIENT(S): Symptomatic postmenopausal women and asymptomatic eumenorrheic women. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Brain activation measured by functional magnetic resonance imaging. RESULT(S): Significant (P<.001) areas of activation during hot flashes in symptomatic women included the insula and anterior cingulate cortex. Sweating in the eumenorrheic women was associated (P<.001) with activity in the anterior cingulate and superior frontal gyrus. CONCLUSION(S): Activation of the insular cortex is associated with the "rush of heat" described during menopausal hot flashes. Thermoregulation in humans appears to be represented in a distributed cortico-subcortical network rather than in a single localized structure.

Adult↗

PubMed2001

Soy product intake and hot flashes in Japanese women: results from a community-based prospective study.

The association between soy product intake and the occurrence of hot flashes was examined in a cohort of 1,106 female residents of Takayama, Gifu, JAPAN: The women were aged 35-54 years and premenopausal at their entry into the study in 1992. Diet, including intake of soy products and isoflavones, was assessed by means of a validated semiquantitative food frequency questionnaire at study entry. A follow-up mail questionnaire asking about experiences of hot flashes was sent in 1998. During the 6 years of the study period, 101 women had new moderate or severe hot flashes according to the Kupperman test of menopausal distress. After data were controlled for age, total energy intake, and menopausal status, hot flashes were significantly inversely associated with consumption of soy products in terms of both total amount (highest tertile of soy product intake (g/day) vs. lowest: hazard ratio = 0.47; 95% confidence interval: 0.28, 0.79; p for trend = 0.005) and isoflavone intake (highest tertile of isoflavone intake (mg/day) vs. lowest: hazard ratio = 0.42; 95% confidence interval: 0.25, 0.72; p for trend = 0.002). These data suggest that consumption of soy products has a protective effect against hot flashes.

Adult↗

PubMed2004

[Treatment of hot flashes in women with a previous diagnosis of breast cancer].

Due to the huge prescription of adjuvant chemotherapy and hormonotherapy, the number of breast cancer survivors with hot flashes is to raise. Hormone replacement therapy is typically withheld from women with previous breast cancer. Treatment should begin with a careful patient history, with specific attention to the frequency and severity of hot flashes and their effect on the individual's function. For mild symptoms that do not interfere with sleep or daily activity, behavioural changes or treatments like soy phyto-oetrogens or vitamin E could be a reasonable initial approach. For more severe symptoms, several alternative substances have therefore been investigated. The use of clonidine and gabapentine should be discouraged because of their modest efficacy and adverse effects. Newer antidepressants (selective serotonin reuptake inhibitors) that are the best studied drugs to date, appear promising as therapy for women with hot flashes. The decrease in hot flashes achieved with progestational agents is similar to that seen with oestrogen therapy but there is debate about the safety of long term use of progestational agents in patients with a history of breast cancer. If hot flashes are particularly troublesome and do not respond to alternative approaches, quality of life must be balanced against theoretical risk of tumour promotion before choosing to use hormone replacement therapy to control these symptoms.

Adult↗

PubMedDate not supplied

Isoflavone supplements containing predominantly genistein reduce hot flash symptoms: a critical review of published studies.

OBJECTIVE: Several reviews have evaluated the clinical evidence relating isoflavone treatment to the relief of menopausal hot flash symptoms. The majority of these reviews included a variety of isoflavone sources, often without discriminating between the identities of individual isoflavones contained in the study product. An evaluation of published studies using well-characterized isoflavone-containing supplements was conducted to determine whether the observed effects, or lack thereof, were attributable to differences in the composition of isoflavones in study products. DESIGN: Eleven studies that met the inclusion criteria were stratified according to specific isoflavone composition. RESULTS: All 11 studies contained similar total isoflavone doses. In five studies, involving a total of 177 treated participants, the study product provided more than 15 mg genistein (calculated as aglycone equivalents) per treatment. Each of these five studies consistently reported a statistically significant decrease in hot flash symptoms. In the six studies involving a total of 201 treated participants that provided less than 15 mg genistein per treatment, only one reported a statistically significant decrease in hot flash symptoms. Thus, the reduction in hot flashes was related to genistein dose, not total isoflavone content of the treatments. CONCLUSION: Reports concluding that isoflavone supplements do not significantly reduce hot flash symptoms may be incorrect. The lack of discrimination between individual isoflavones contained in heterogeneous isoflavone mixtures from differing sources can be misleading when designing studies, interpreting results, and conducting reviews. In light of these observations, evaluation of isoflavone effects should focus greater attention to the specific composition within supplements in future studies.

Dietary Supplements↗

PubMedDate not supplied

Prevalence and predictors of night sweats, day sweats, and hot flashes in older primary care patients: an OKPRN study.

PURPOSE: We wanted to estimate the prevalence of night sweats, day sweats, and hot flashes in older primary care patients and identify associated factors. METHODS: We undertook a cross-sectional study of patients older than 64 years recruited from the practices of 23 family physicians. Variables included sociodemographic information, health habits, chronic medical problems, symptoms, quality of life, and the degree to which patients were bothered by night sweats, daytime sweating, and hot flashes. RESULTS: Among the 795 patients, 10% reported being bothered by night sweats, 9% by day sweats, and 8% by hot flashes. Eighteen percent reported at least 1 of these symptoms. The 3 symptoms were strongly correlated. Factors associated with night sweats in the multivariate models were age (odds ratio [OR] 0.94/y; 95% confidence interval [CI], 0.89-0.98), fever (OR 12.60; 95% CI, 6.58-24.14), muscle cramps (OR 2.84; 95% CI, 1.53-5.24), numbness of hands and feet (OR 3.34; 95% CI, 1.92-5.81), impaired vision (OR 2.45; 95% CI, 1.41-4.27), and hearing loss (OR 1.84; 95% CI, 1.03-3.27). Day sweats were associated with fever (OR 4.10; 95% CI, 2.14-7.87), restless legs (OR 3.22; 95% CI, 1.76-5.89), lightheadedness (OR 2.24; 95% CI, 1.30-3.88), and diabetes (OR 2.19; 95% CI, 1.22-3.92). Hot flashes were associated with nonwhite race (OR 3.10; 95% CI, 1.60-5.98), fever (OR 3.98; 95% CI, 1.97-8.04), bone pain (OR 2.31; CI 95%: 1.30-4.08), impaired vision (OR 2.12; 95% CI, 1.19-3.79), and nervous spells (OR 1.87; 95% CI, 1.01-3.46). All 3 symptoms were associated with reduced quality of life. CONCLUSION: Many older patients are bothered by night sweats, day sweats, and hot flashes. Though these symptoms are similar and related, they have somewhat different associations with other variables. Clinical evaluation should include questions about febrile illnesses, sensory deficits, anxiety, depression, pain, muscle cramps, and restless legs syndrome.

Aged↗

PubMed1989

Laboratory and ambulatory monitoring of menopausal hot flashes.

A large increase in skin conductance activity recorded from the sternum was found during menopausal hot flashes and corresponded well with patient self-reports. The magnitude and time course of this skin conductance change was similar during spontaneous hot flashes recorded in the laboratory, during heat-induced hot flashes, and during those recorded by ambulatory monitoring techniques. This pattern of sternal skin conductance change did not occur in premenopausal women during body heating or ambulatory monitoring. These methods should be useful in research on the etiology and treatment of menopausal hot flashes.

Adult↗

PubMed1999

Progressive prostate cancer associated with use of megestrol acetate administered for control of hot flashes.

Low doses of megestrol acetate are frequently used for treatment of hot flashes in men having androgen ablation for prostate cancer. We report a case in which megestrol acetate (20 mg bid) was administered for symptomatic control of hot flashes in a medically castrated patient with prostate cancer. The patient was subsequently noted to have a rising prostate-specific antigen (PSA) level. Megestrol acetate administration was discontinued, and the PSA level declined. These data indicate that even the low doses of megestrol acetate used for control of hot flashes can be associated with PSA increases in some patients with prostate cancer.

Aged↗

PubMed2003

Hot flashes--a review of the literature on alternative and complementary treatment approaches.

Hot flashes are a common experience for menopausal women, with an 85-percent incidence in the West. With the increased knowledge of side effects attributable to conventional treatment options, more women are exploring natural alternatives. Although more definitive research is necessary, several natural therapies show promise in treating hot flashes without the risks associated with conventional therapies. Soy and other phytoestrogens, black cohosh, evening primrose oil, vitamin E, the bioflavonoid hesperidin with vitamin C, ferulic acid, acupuncture treatment, and regular aerobic exercise have been shown effective in treating hot flashes in menopausal women.

Female↗

PubMedDate not supplied

A randomized controlled trial of the effect of dietary soy and flaxseed muffins on quality of life and hot flashes during menopause.

OBJECTIVE: To compare the effects of daily ingestion of soy flour (S), ground flaxseed (F), or wheat flour (W) muffins, on quality of life and hot flash frequency and severity in postmenopausal women. DESIGN: This was a double-blind, randomized, controlled, intention-to-treat trial. Ninety-nine women, 1 to 8 years after menopause, ingested muffins with 25 g of flaxseed (50 mg of lignans), 25 g of soy (42 mg of isoflavones), or wheat (control) daily for 16 weeks. Subjects completed the Menopause-specific Quality of Life instrument monthly along with daily hot flash frequency and severity diaries. Compliance measures included a 3-day food diary and urinary isoflavone and lignan analyses at weeks 0 and 16 and returned muffin counts monthly. RESULTS: Eighty-seven women (28, ground flaxseed muffins; 31, soy flour muffins; and 28, wheat flour muffins) completed the trial. Multivariate analysis of variance of all quality-of-life domains yielded an insignificant treatment x time interaction (F46,122 = 0.92, P = 0.62) but a significant time main effect (P <.0001). Repeated-measures analyses of covariance controlling for body mass index showed no significant group x time interaction nor time nor group differences on all quality-of-life domains and hot flash measures except severity. Hot flashes were less severe with flaxseed (P = 0.001) compared to placebo; however, the group x by time interaction was not significant. Phytoestrogen excretion analysis showed treatment group exposure as allocated and no contamination. CONCLUSION: Neither dietary flaxseed nor soy flour significantly affected menopause-specific quality of life or hot flash symptoms in this study.

Diet Records↗

PubMed2005

Hot flash experience in men with prostate cancer: a concept analysis.

PURPOSE/OBJECTIVES: To provide a clear definition of the hot flash experience in men with prostate cancer receiving hormonal treatment. DATA SOURCES: Articles, book chapters, and electronic sources. DATA SYNTHESIS: The hot flash experience has not been explored previously in men with prostate cancer. The physiologic and psychological scopes of the phenomenon are described as a multidimensional experience. CONCLUSIONS: The essential attributes of hot flashes in men consist of physiologic (e.g., warmth, sweating, chills) and psychological (e.g., anxiety, impaired memory, agitation) factors. Antecedents to the experience include demographics, disease, and treatment modality. Consequences include effects on sleep, cognition, and health-related quality of life. IMPLICATIONS FOR NURSING: Evaluation of the hot flash experience in men receiving hormonal ablation should include assessment of the symptoms associated with the treatment modality and nursing interventions to help ameliorate symptoms. Future research is needed to focus on providing symptom management to decrease the severity or prevent the occurrence of multiple symptoms related to androgen ablation therapy.

Aged↗

PubMed1981

Menopausal hot flashes: their cycles and relation to air temperature.

The occurrence of hot flashes was investigated exhaustively in 1 woman. She recorded the clock time of each hot flash in a notebook for 100 days. Fluctuations were circadian and day to day with sawtoothed periodicity. The circadian peak was always between 18 and 21 hours. The circadian nadir and the mean daily rate varied directly with outdoor temperature. The occurrence of hot flashes was not related to internal body temperature, and hence not to environmental heating or cooling of the body. Therefore impulses from temperature receptors altered the rate of formation and release of a hypothetic central nervous system neurohumor that stimulated the hypothalamic heat loss center. This mechanism did not exhibit acclimatization to heat. Comparably thorough studies on more women are needed.

Body Temperature↗

PubMed1979

Investigation of hot flashes by ambulatory monitoring.

The unpredictability of hot flashes makes their investigation difficult. A method for continuous monitoring of subjective arousals and their objective correlates is here described and illustrated with results from one subject. Temperatures of special interest with respect to hot flashes--toe, cheek, vagina, and air--were recorded on a protable magnetic tape during routine living at home. The subject signaled the "on" and "off" of each perceived flash with a hand switch and also entered information in a notebook. She signaled 63 flashes on 5 days, during which the cheek and toe temperatures showed transient increments. Some of the flashes were labeled uncertain in the notebook. The subject also had 23 episodes of these temperature increments that she did not identify by signals as flashes. In these episodes, therefore, the mechanism of consciousness was not activated. Perceptions that coincided with transient temperature increments thus ranged as follows: subconscious, uncertain, definite but bearable, mildly distressful, and strongly distressful. Hence ambulatory monitoring can provide objective evidence of transient activation of the hypothalamic heat loss mechanism, whether perceived or not.

Body Temperature↗

PubMed2003

Phytoestrogen supplements for the treatment of hot flashes: the Isoflavone Clover Extract (ICE) Study: a randomized controlled trial.

CONTEXT: Clinical trials demonstrating increased risk of cardiovascular disease and breast cancer among women randomized to hormone replacement therapy have increased interest in other therapies for menopausal symptoms. Dietary supplements containing isoflavones are widely used as alternatives to hormonal therapies for hot flashes, but there is a paucity of data supporting their efficacy. OBJECTIVE: To compare the efficacy and safety of 2 dietary supplements derived from red clover with placebo in symptomatic menopausal women. DESIGN, SETTING, AND PARTICIPANTS: Randomized, double-blind, placebo-controlled trial of menopausal women, aged 45 to 60 years, who were experiencing at least 35 hot flashes per week. The study was conducted between November 1999 and March 2001 at 3 US medical centers and included women who were recently postmenopausal (mean [SD], 3.3 [4.5] years since menopause) experiencing 8.1 hot flashes per day. Women were excluded if they were vegetarians, consumed soy products more than once per week, or took medications affecting isoflavone absorption. INTERVENTION: After a 2-week placebo run-in, 252 participants were randomly assigned to Promensil (82 mg of total isoflavones per day), Rimostil (57 mg of total isoflavones per day), or an identical placebo, and followed-up for 12 weeks. MAIN OUTCOME MEASURE: The primary outcome measure was the change in frequency of hot flashes measured by participant daily diaries. Secondary outcome measures included changes in quality of life and adverse events. RESULTS: Of 252 participants, 246 (98%) completed the 12-week protocol. The reductions in mean daily hot flash count at 12 weeks were similar for the Promensil (5.1), Rimostil (5.4), and placebo (5.0) groups. In comparison with the placebo group, participants in the Promensil group (41%; 95% confidence interval [CI], 29%-51%; P =.03), but not in the Rimostil group (34%; 95% CI, 22%-46%; P =.74) reduced hot flashes more rapidly. Quality-of-life improvements and adverse events were comparable in the 3 groups. CONCLUSION: Although the study provides some evidence for a biological effect of Promensil, neither supplement had a clinically important effect on hot flashes or other symptoms of menopause.

Dietary Supplements↗