PubMed HealthSearch

SEARCH · PubMed Health

Results for “Hot Flashes”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 19 recordsLinked to original sources

Effect of fever on menopausal hot flashes.

Some women report that they have fewer hot flashes when they have a fever. This is the first case of physiological monitoring of hot flashes during fever in a subject with a well documented pattern of frequent hot flashes when afebrile. During fever, there were fewer hot flashes than during afebrile periods, and these hot flashes also tended to be less intense. For most of the period of reduced hot flashes, internal (core) temperature was elevated, above 37.5 degrees C. When the fever broke, hot flashes resumed in a pattern similar to that of afebrile periods. Possible explanations for the reduction in hot flashes during a fever include: (1) a hot flash is triggered, but the characteristic physiological changes do not occur due to competing thermoregulatory drives, (2) the febrile core temperature inhibits whatever it is that triggers a hot flash; or (3) some product of the fever process inhibits the hot flash trigger or masks the physiological changes that occur during hot flashes.

Body Temperature

Treatment of Hot Flashes in Men With Prostate Cancer Undergoing Androgen Deprivation Therapy.

BACKGROUND: Hot flashes are common and often debilitating side effects of castration therapy; a cornerstone in the treatment of metastatic prostate cancer (PCa) as well as in localized or locally advanced PCa when combined with radiotherapy. The evidence for relieving vasomotor symptoms is limited. This systematic review presents both pharmacological and non-pharmacological interventions for treating hot flashes in men with PCa undergoing castration therapy, primarily androgen deprivation therapy (ADT). METHODS: a systematic literature search was conducted in PubMed using ("hot flash*" OR "hot flush*" OR "vasomotor*") AND ("prostate") as keywords. Studies with intervention for hot flashes due to castration therapy, estimation of treatment response (e.g., reduction in frequency or impact on quality of life) and patients with PCa (any stage) were eligible. RESULTS: Of 469 papers, 35 were included in the review. The included studies evaluated cyproterone acetate, estrogen or estrogen derivatives, progesterone derivatives, selective serotonin reuptake inhibitors (SSRIs), gabapentin, oxybutynin, and clonidine, as well as non-pharmacological interventions such as acupuncture, cognitive behavioral therapy (CBT), and dietary supplements (e.g., Dong Quai/Angelica Sinensis, Serelys Homme, soy protein, and Salvia officinalis). Across all blinded pharmacological interventions, the relative reduction in hot flash frequency ranged from -21% to -84%, and the placebo effect was between -19% and -30%. CONCLUSION: Hormonal agents such as cyproterone acetate and estrogen appear to be the most effective treatments, although they are associated with side effects. Non-pharmacological options like acupuncture and CBT may offer some benefit, while dietary supplements seem to be ineffective. Future studies are needed also to evaluate newer treatments, such as fezolinetant, in this patient population.

Humans

LH, FSH and skin temperaure during the menopausal hot flash.

Six postmenopausal women, who were experiencing frequent hot flashes, had an 8 h continuous recording of skin temperature over the dorsum of the finger as an objective index of hot flashes. Frequent blood samples were obtained during the time of the recording for the measurement of serum luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels. During the 48 h of recording 34 significant temperature elevations were recorded and 32 were associated with a subjective hot flash. 3l pulses of LH release were also observed with 26 occurring simultaneously with the temperature rises. Correlation analysis of simultaneous skin temperature and circulating LH levels showed a significant positive correlation (p less than 0.01). FSH levels showed no consistent relationship with skin temperature. These data suggest that LH or the factors that trigger its pulsatile release are related to the mechanism responsible for the initiation of hot flashes.

Climacteric

Body temperatures during menopausal hot flashes.

Body temperatures during hot flashes were measured in a menopausal woman. Internal temperatures fell after each flash; lowest: rectal, 35.6 degrees C; vaginal, 35.6 degrees C; tympanic, 35.2 degrees C. Where sweating occurred, the skin temperature fell during the flash and rose after it. Finger and toe temperatures always showed a sharp rise at the onset of a flash with a slower fall after the flash. Only the cheeks showed additional temperature rises; maximum, 0.7 degrees C. The heart accelerated 13% at the onset of the flash but slowed immediately thereafter. The flash interval was sharply demarcated by undulations in the ECG baseline. There was never any premonitory sign of the imminence of a flash. A central excitatory state seemed to build up, perhaps by the accumulation of a chemical compound, but not of heat, which was explosively dischargedmthe thermal distress was probably evoked by vascular warming in the cheeks. Dabbing the malar prominences with cold water brought prompt relief.

Body Temperature

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

Elevations in skin temperature of the finger as an objective index of postmenopausal hot flashes: standardization of the technique.

The present study was designed to validate and standardize a technique of continuous recording of skin temperature of the finger as an objective index of hot flashes. Significant skin temperature rises (greater than 1 degree C) were recorded in close temporal relationship to 69% of subjective hot flashes experienced by seven postmenopausal women. The temperature elevations occurred at an interval of 54 +/- 10 minutes (mean +/- standard error) and lasted an average of 31 minutes. The mean increase was 2.7 degrees +/- 0.2 degrees C. The extent of the temperature elevations found in the postmenopausal subjects was significantly greater than in premenopausal control subjects (P less than 0.05) and was reduced by estrogen treatment (P less than 0.02). This study substantiates that the recording of skin temperature changes of the finger provides an objective index of hot flashes. This should assist in the investigation of the underlying disturbance and provide more accurate evaluation of modes of therapy.

Adult

[The relation between dysmenorrhea and hot flash in a group of women in climacteric].

Hot flushes in climacteric age can cause noticeable discomfort to those who have them. This functional disturbance confirms the strong relationship between the gonadic steroids and the central neurotransmitters. These complex mechanisms which control reproductive functions limit our knowledge of the pathogenesis of hot flushes. The possible intervention of prostaglandins in the rising of this disturbance and their participation in dismenorrhea have raised the hypothesis that the prostaglandins may be the common denominator in the development of dysmenorrhea in fertile age women and of hot flushes in climacteric age women. Under this context, we examined a number of women in menopause to determine if they suffered with dysmenorrhea in fertile age.

Adult

Use of medroxyprogesterone acetate to prevent menopausal symptoms.

A number of patients with severe vasomotor symptoms of menopause, specifically hot flashes, are unable to take exogenous estrogens because of intolerance of contraindications. Others achieve less than satisfactory relief of symptoms with extrogen. A double-blind study was established to determine whether depomedroxyprogesterone acetate (DMPA) injectable (Depo-Provera, Upjohn) could be used as a satisfactory substitute in these patients. The basis of the study was to evaluate clinical impressions that some menopausal patients taking DMPA for other purposes achieved relief from these distressing symptoms. Fifty-seven patients were treated with DMPA, 150 mg IM monthly, and 12 controls were given 1.5 ml sterile saline IM monthly. Serum FSH and LH were measured initially and serially. Clinical response was determined by the patients' estimates of the frequency and severity of their hot flashes. Of 57 patients in the treatment group, 51 (89.5%) were relieved of symptoms compared to 3 of 12 (25%) in the control group. DMPA can be an effective alternate to estrogen therapy in selected menopausal patients.

Adult

The position of cyproterone acetate (CPA), a steroidal anti-androgen, in the treatment of prostate cancer.

Cyproterone acetate is a steroidal anti-androgen that blocks the androgen-receptor interaction and reduces serum testosterone through its weak anti-gonadotropic action. It can be regarded as the only anti-hormone that causes complete androgen blockade as monotherapy. Many animal experiments and several clinical phase II and phase III trials have demonstrated that it deserves a place in the endocrine therapy of advanced prostate cancer, particularly for those patients who find orchidectomy unacceptable and who do not have known cardiovascular risks. Additionally, cyproterone acetate can be used safely to prevent disease flare when a luteinizing hormone releasing hormone analog is the drug of choice and to suppress hot flashes in response to LHRH agonists or after orchidectomy.

Androgen Antagonists

Casodex: a pure non-steroidal anti-androgen used as monotherapy in advanced prostate cancer.

Casodex, a pure potent non-steroidal anti-androgen, has been shown in a phase II clinical trial program to be very well tolerated and to have fewer side-effects compared with other anti-androgens. The most commonly reported side-effects (prompted by direct questioning) were breast tenderness (63.4%), breast swelling (52.5%), and hot flashes (23.6%). Gastrointestinal disturbances, hepatic impairment, alcohol intolerance, and problems with light adaptation are not associated with Casodex treatment. In this study, Casodex (50 mg once daily) was evaluated in 267 patients, 130 of whom have received it for more than 1 year. On assessment of best objective response, 55.5% of patients showed partial regression, 15.6% stable disease, 17.1% progression, and 11.8% were not assessable. These results are comparable with other standard hormonal therapies for advanced prostate cancer.

Aged

Phase I study of the tolerance and pharmacokinetics of toremifene in patients with cancer.

Toremifene is a triphenylethylene derivative structurally and pharmacologically similar to tamoxifen. This Phase I trial assessed the safety, pharmacokinetics, anti-estrogenic, and estrogenic effects of toremifene at six dose levels (10, 20, 40, 60, 200, and 400 mg/day). The most common side-effects associated with therapy included gastrointestinal (nausea/vomiting 43%), anti-estrogenic (hot flashes 29%), and CNS (dizziness/vertigo 12%). Three patients with bone metastases from breast cancer developed hypercalcemia. At doses greater than or equal to 40 mg/day a decline in LH and FSH occurred which was not statistically significant. At all doses tested SHBG rose during therapy. A dose dependent estrogenic blockade was seen on the vaginal epithelium following challenge with transdermal estradiol. Steady-state concentrations of toremifene were reached within 4 weeks, and at doses greater than or equal to 60 mg/day ranged from 879-3445 ng/ml. The half-life was found to be 5 days, and at three weeks following discontinuation of treatment concentrations greater than 24 ng/ml were detected. The N-desmethyl and 4-hydroxy metabolites achieved steady state levels within 4 weeks and had half-lives of 6 and 5 days respectively. Partial responses were seen in 4 patients, 3 with breast cancer treated at 200 mg/day and 1 with endometrial cancer treated at 400 mg/day.

Adult

Long-term therapy with slow-release nifedipine in essential hypertension.

The purpose of this study, designed as an open multicenter trial, was to test the antihypertensive efficacy, patient acceptability, and side effects of long-term treatment with slow-release nifedipine in a large population. The drug was studied in 330 outpatients with essential hypertension, WHO stage 1-2, recruited in 20 hospital centers. After washout period was completed, nifedipine (20 mg bid) was given for 1 month (phase 1). Then, the treatment was extended for 4 months (phase 2) with variable doses (range 20-80 mg daily). No other antihypertensive drugs were administered during phase 1. However diuretics, beta blockers, or captopril were added to nifedipine during phase 2 in 11 patients. Seventy patients did not meet criteria for inclusion at washout. During phase 1 and 2, 66 additional patients were excluded due to side effects, the need of other antihypertensive drugs, or non-compliance. Systolic blood pressure significantly lowered (10% or more) in 84% patients in phase 1 and in 76% in phase 2. No responders were 6.1% and 3.6%, respectively. Diastolic blood pressure was normalized in 60% of patients after 5 months of therapy. Effects on blood pressure were equal in young patients and in the elderly, but a minimal rise in heart rate was recorded in younger patients. At least one side effect occurred in 46.6% patients, mainly headache (15.4%), hot flashes (13.3%), ankle edema (12.8%), or palpitation (6.6%). Sixteen patients (8.2%) were obliged to stop nifedipine treatment due to the severity of the side effects. This trial confirms the efficacy of nifedipine in hypertension, both in young and in aged patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Efficacy and safety of nafarelin in the treatment of endometriosis.

The efficacy and safety of the gonadotropin-releasing hormone agonist nafarelin for treatment of endometriosis were compared with those of danazol in two large-scale, double-blind trials. Assessments of severity of symptoms, laparoscopic scores before and after therapy, and pregnancy rates showed that nafarelin, 400 and 800 micrograms administered intranasally, was as efficacious as oral danazol, 600 and 800 mg. The adverse effects seen with nafarelin, mainly hot flashes, were related to its mode of action, namely hypoestrogenemia induced by reversible inhibition of ovarian hormone production. Hypoestrogenemia was associated with a decrease of bone density in the lumbar vertebrae, but these changes were partially or completely reversible after treatment was discontinued. No significant changes in bone mass occurred in the distal radius. Danazol was associated with androgenic and metabolic adverse effects, including weight gain, negative effects on the lipid profile, and elevated liver enzyme levels. Nafarelin was found to be as effective as danazol for the management of endometriosis, with a different and more favorable safety profile.

Danazol

Nafarelin in the management of endometriosis: quality of life assessment.

Quality of life is important when comparing the relative advantages of nafarelin versus danazol for the treatment of endometriosis. Recent studies have investigated the potential differences between the safety profiles of nafarelin and danazol and the impact of these profiles on the patient's quality of life. Results show that although these drugs have similar efficacy, they are associated with very different safety profiles. Most notable are the androgenic effects such as weight gain associated with danazol. With nafarelin, hypoestrogenic side effects, such as hot flashes, are more common. More important, these differences in safety profiles may prove to be relevant to patient satisfaction and compliance with therapy.

Climacteric

Gonadotropin-releasing hormone agonists: strategies for managing the hypoestrogenic effects of therapy.

Gonadotropin-releasing hormone agonists have been shown to be comparable with danazol for the treatment of endometriosis. These results are important because danazol is associated with a significant number of side effects, particularly androgenic effects, such as weight gain and acne. Although gonadotropin-releasing hormone agonists are associated with hypoestrogenic side effects, such as hot flashes and reversible bone density loss, recent studies suggest that the risk of these side effects may be modified when gonadotropin-releasing hormone agonists are combined with a progestin. These findings suggest that such regimens may further enhance the clinical usefulness of gonadotropin-releasing hormone agonist therapy for endometriosis and other estrogen-mediated diseases.

Bone Density

Zoladex versus orchiectomy in treatment of advanced prostate cancer: a randomized trial. Zoladex Prostate Study Group.

We report preliminary results for the first 164 patients enrolled in a multicenter study comparing the endocrine effects, efficacy, and safety of 3.6 mg of goserelin acetate (Zoladex) and orchiectomy in patients with Stage D2 prostate cancer. Eighty-one patients were randomly allocated to receive Zoladex and 83 to orchiectomy. The median follow-up time for all patients was two hundred ten days. Median serum levels of testosterone were reduced to castrate levels (less than 50 ng/dL) within four weeks in both groups and remained suppressed for up to sixty weeks. An objective response according to modified criteria of the National Prostatic Cancer Project was observed in 81 percent and 78 percent of patients in the Zoladex and orchiectomy groups, respectively. There were no statistically significant differences between treatment groups in the distributions of time to treatment failure or time to disease progression. The most commonly reported adverse events in both treatment groups were hot flashes, cancer-related pain, unspecified pain, and urinary symptoms. These results suggest that Zoladex may offer an alternative to orchiectomy in the treatment of advanced prostate cancer.

Acid Phosphatase