Though some medical experts readily prescribe some form of hormone therapy for the relief of vasomotor symptoms, these treatments aren't appropriate for all women. Women with active endometrial or breast cancers, for example, usually must avoid hormone therapy during cancer treatment. Medical professionals rarely prescribe hormone therapy for women with a personal or family history of blood clotting, liver disease, or other conditions that can be triggered or exacerbated by hormone treatments.
Medications That Can Help
To provide relief from hot flashes for women who cannot take estrogen, medical professionals can prescribe other medications that have been shown to offer some relief from hot flashes. The following list mentions some of these prescription medications for alleviating hot flashes:
Clonidine hydrochloride reduces the responsiveness of the body's vascular system, and has been used for some time in the treatment of high blood pressure. A low dose is used and it may take three to four weeks to begin to see improvement in symptoms; blood pressure must also be monitored. Clonidine does have some negative side effects and can disrupt the sleep of some women. Other side effects reported include dizziness and dry mouth.
Methyldopa is another antihypertensive (high blood pressure medication) sometimes used to relieve vasomotor symptoms. Though methyldopa has been shown to reduce the number of hot flashes women experience during the day, it can cause dry mouth, dizziness, and headaches.
Selective serotonin reuptake inhibitors (SSRIs), including paroxetine, fluoxetine, and venlafaxine, are also used to lessen vasomotor symptoms, although they are not approved by the Food and Drug Administration (FDA) for that purpose. In higher doses, these drugs are used to treat depression. Some tests have shown that relatively low doses of these drugs can reduce the frequency and severity of hot flashes anywhere from 19 to 60 percent, depending upon the specific drug and dosage strategy. Side effects of these drugs include dry mouth, nausea, and anxiety.
Bellergal, a drug that combines very low dosages of belladonna and phenobarbital, is an FDA-approved medication for the treatment of menopausal symptoms. This drug has been used for decades in the short-term treatment of hot flashes, with varying success. Bellergal can have a number of unpleasant side effects, including constipation, dry mouth, and dizziness.
Gabapentin is an anti-seizure medication that is sometimes prescribed for the treatment of hot flashes. In studies, 70 percent of women reported that they had a noticeable improvement in their symptoms. The long-term effects are not yet known, but one study showed gabapentin to be as effective as estrogen in reducing hot flashes, when compared to placebo. Side effects, which are lower if the medication is taken with meals, may include fatigue, dizziness, swelling of hands and feet, and skin rash.
Many of the nonhormonal treatments for hot flashes and other menopause symptoms are controversial, and their effectiveness, safety, and possible side effects and interactions with other medications remain the subject of ongoing studies.
What's Best for You?
If hot flashes are making your life miserable, there are treatments that can help. You have to decide whether your symptoms are serious enough to need medical intervention and prescription medications. Short-term treatment for the relief of hot flashes is very common, but your own unique risks and family history need to be considered. Be honest with your care provider about the severity of your hot flashes so that together you can decide what, if any, medication would work best for you. If you think you'd like to try some non-prescription medications to treat your symptoms, ask your health care provider for suggestions. The following section discusses some of the common ones.