Hot flashes can cause a variety of uncomfortable symptoms in early
menopause. It can cause a feeling of warmth that spreads through upper body and face, flushing of face and neck, sweating, and rapid heart rate. Most women have mild to moderate symptoms that can be managed through lifestyle changes. Some women may have more severe symptoms that interfere with their daily activities.
Hormone replacements therapy
(HRT) with estrogen is an effective treatment. However, recent concerns about the safety of HRT have lead to efforts to find alternative therapies. Some studies have shown that antidepressant medication may provide some relief.
Researchers from the Eastern Virginia Medical School reviewed the benefits and risks of an antidepressant drug called
desvenlafaxine. The study found that the drug may be effective in relieving hot flash symptoms.
The study was a
randomized trial, comparing the effects of desvenlafaxine to a
placebo. The study followed 567 healthy postmenopausal women who had reported at least 50 moderate to severe hot flashes weekly. The women were randomly divided into one of three groups:
- Placebo
- Desvenlafaxine 100 mg
- Desvenlafaxine 150 mg
Each week the women were asked to record the number and severity of the hot flashes. After 12 weeks, compared to their records at the beginning of the study, the women reported:
- 4.9 fewer hot flashes per week in the placebo group
- 6.3 fewer flashes per week in the desvenlafaxone 100 mg group
- 7.0 fewer flashes per week in the desvenlafaxone 150 mg group
During the first week there was a higher drop-out rate for women in the desvenlafaxine groups than the placebo groups. This was probably linked to the negative side effects of the drug, including loss of appetite,
constipation,
diarrhea, dry mouth, nausea,
insomnia, and dizziness.
This study was a follow-up to a previous clinical trial. The earlier study published in the journal
Obstetrics and Gynecology, also found this drug to be effective in treatment of hot flashes. These new results seem to confirm the benefits of desvenlafaxine to relieve hot flashes.
Mild to moderate hot flashes can usually be managed through
lifestyle changes. However, if they are significantly interfering with your personal and professional lives, talk to your doctor about treatment options. Although desvenlafaxine and similar medications are not without their side effects, at this point, it appears they are likely to be safer than HRT over the long term. Hot flashes last about 1-2 years without treatment.
American Congress of Obstetricians and Gynecologists
www.acog.org/
Last reviewed April 2009 by Richard Glickman-Simon, MD
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