During perimenopause and menopause, hot flashes can occur at any time of the day or night. Heat rises through your body. Your face, neck, and chest may turn red and you may start to sweat. And it’s more than just a pain in the neck – hot flashes, especially when they’re severe, can be really bothersome. In fact, about three in ten women with hot flashes suffer enough to require treatment.
Hot flashes — one of the two vasomotor symptoms (VMS) of menopause — occur when a hormone in your body called estrogen begins to decline. Estrogen affects the part of your brain that controls body temperature. Up to 8 in 10 premenopausal and postmenopausal women experience hot flashes that can last anywhere from seven to 10 years—and black and Hispanic women often experience hot flashes even longer.
The most effective treatment for hot flashes is hormone therapy (HT). However, not all women can take hormonal medications for various reasons. “This includes women who have suffered from estrogen-sensitive breast or uterine cancer, heart attack, stroke, blood clots or pulmonary embolism,” said Dr. JoAnn Pinkerton, Medical Director of Midlife Health Center and member of HealthyWomen’s Women’s Health Advisory Council. Other women may choose not to take HT for personal reasons.
Now these women have a new option. In October, the U.S. Food and Drug Administration (FDA) approved a new hormone-free drug called elinzanetant to treat moderate to severe hot flashes. It joins fezolinetant, which was approved for the same indication in 2023. With more non-hormonal treatments available than ever before, it can be difficult to know which is right for you.
Here’s what you need to know about treating hot flashes.
Non-hormonal medications for hot flashes
Two new hormone-free drugs target the brain’s temperature control center to reduce hot flashes. The drugs stop hot flashes by counteracting the drop in estrogen by binding to and blocking the parts of your brain that allow temperature to rise when your hormone levels drop.
Elinzanetant (Brand name: link): In clinical trials, elinzanetant reduced hot flashes by 73% and also helped women sleep better.
Common side effects of elinzanetant:
- sleepiness
- Headache
- stomach pain
Fezolinetant (Brand name: Veozah): It has been shown to improve mood, sleep and overall quality of life.
Common side effects of fezolinetant include:
- Stomach pain
- insomnia
- Increased liver enzymes
It is always important to talk to your doctor about whether a prescription medication is right for you. Elinzanetant and fezolinetant can affect the way certain medications work. Therefore, it is important to tell them what else you are taking.
Both non-hormonal agents used to treat hot flashes are processed by the liver. Therefore, you need to have your liver checked every three months if you take it. And for fezolinetant, you need to have a baseline liver test done before starting. As with all medications, certain people should not take these medications.
Elinzanetant and fezolinetant can also be expensive and may not be covered by insurance. However, you may be able to find coupons and savings opportunities on their websites or ask your pharmacist.
Off-label medications
Some medications that are not specifically intended for hot flashes have been shown to help relieve VMS symptoms. Pinkerton said more research is needed to understand why, but these drugs appear to have an impact on the temperature regulator in your brain.
Antidepressants, including SSRIs and SNRIs, reduce hot flashes in up to 64% of women. These can be a good choice for women struggling with depression or anxiety and experiencing VMS symptoms.
Side effects of SSRIs and SNRIs can include:
- nausea
- Gastrointestinal problems
- Weight changes
- Headache
- Sexual dysfunction
Gabapentin (brand names: Horizant, Gralise and Neurontin) is a nerve blocker that can help reduce the severity of hot flashes by up to 51%. Because it can make you sleepy, it is often prescribed to women with hot flashes and trouble sleeping. Since it is a nerve blocker, it may also be an option for women with neuropathic pain.
Gabapentin side effects may include:
- dizziness
- Coordination difficulties
- Weight gain
- swelling
- Gastrointestinal problems.
Oxybutynin (brand name: Ditropan) is an overactive bladder medication that can reduce hot flashes by up to 86%. This can be a good choice for women who experience both urinary problems and hot flashes.
Oxybutynin side effects include:
- Dry eyes
- Dry mouth
- Urine retention
- dizziness
- sleepiness
- constipation
- nausea
Dietary supplements for hot flashes
Over-the-counter hot flash supplements contain vitamins, minerals, amino acids, and other ingredients that may help relieve symptoms. Pinkerton said these options can help women with mild to moderate symptoms, but they won’t help with severe symptoms. She also warned that they are not FDA-approved, meaning they are unregulated, may not be proven to help, and may contain harmful substances.
EstroG-100 is a dietary supplement with roots in Asian folk medicine. In one study, EstroG-100 reduced hot flashes after 12 weeks of use. It may also help with other menopausal symptoms, including sleep problems.
S-Equol is a soy-based product that may benefit some, but not all, menopausal women. More studies are needed to find out how effective it is.
Black cohosh is an herbal supplement native to North America that is said to ease menopause symptoms. There is limited evidence supporting its use. It may cause mild side effects and may interact with certain medications. Extreme caution should be exercised when using this herbal remedy.
Red clover is an herb native to southeastern Europe that is traditionally used to treat upper respiratory tract infections. There is evidence that red clover can relieve menopausal symptoms, but more clinical studies are needed.
Lifestyle changes for hot flashes
Making certain lifestyle changes can help reduce the severity and number of your hot flashes. Pinkerton recommended moderate exercise, at least seven hours of sleep per night and a Mediterranean diet high in protein, fruits and vegetables. You should also stop smoking and limit your alcohol and caffeine consumption.
An individualized approach based on your symptoms is the best way to combat hot flashes.
If your symptoms are mild, over-the-counter options may work, according to Pinkerton. However, if your hot flashes are affecting your work, sleep, or relationships, it’s a good idea to make an appointment with your HCP. “Make sure someone is listening to you and providing evidence-based therapies,” she said.
From your website articles
Related articles on the Internet
