Posts Tagged "hot flashes"

Wednesday Bubble: hot flashes and antidepressants

Posted by Liz on Jan 19, 2011 in hot flash | 4 comments

Researchers have been studying antidepressant therapy (namely selective serotonin reuptake inhibitors – SSRIs, and serotonin/norepinephrine reuptake inhibitors –SNRIs) for some time now in hopes of discovering an effective treatment for hot flashes and an alternative to hormone replacement therapy (HRT). However, antidepressants’ ability to ameliorate hot flashes have yielded mixed results in the study arena. One potential advantage of using an antidepressant in this regard is the ability to also effectively address mood swings and depression that occur as hormone levels wane and decline throughout menopause. Hence, I was intrigued by a new study, published this week in the Journal of the American Medical Association, that not only evaluated the benefit of using the SSRI Lexapro for hot flashes but also, whether or not factors such as race and coexisting depressed mood and/or anxiety would affect the results. Notably, African-American women are reportedly more likely than report having particularly bothersome hot flashes.

In this particular trial, 205 menopausal or postmenopausal women reporting at least 28 hot flashes or night sweats per week over a three week period that were bothersome or severe the majority of time were asked to take 10 mg escitalopram (Lexapro) or placebo tablet daily for 8 weeks. This dosage was increased midway through the trial if hot flash frequency didn’t decrease by at least 50% and if severity did not change.

The findings:

• More than half of women reported that the frequency of their hot flashes declined by at least 50% from the study starts (compared to slightly more than a third of women taking placebo)
• Women taking Lexapro reported that the severity of their hot flashes decreased by 24% compared to the study’s start (and a 14% decline in severity among the placebo group)
• The response to Lexapro was rapid and improvements started to be seen within one week
• Reported side effects between the two groups were fairly equal, and mostly related to feeling tired, stomach issues and dry mouth
• Race did not appear to play a role in either group
• Hot flashes returned after Lexapro was stopped

Although the researchers caution that the group of women in the study were highly motivated and not necessarily reflective of women in the general population, I would argue that a woman with severe and frequent hot flashes is motivated, period. I’m not a huge fan of using pharmaceutical medications to address menopausal symptoms for two reasons: 1) menopause is not a disease and, 2) as evidenced by the archives, there is an evolving body of literature that supports the use of alternative strategies for managing menopause. Nevertheless, as someone who has had lifelong bouts of depression that are exacerbated by hormones, I welcome an effective alternative to HRT that might be more broadly embraced by the medical community. Until a greater proportion of healthcare practitioners begins to accept the distinctions between between eastern and western medical philosophies and the potential advantages of complementary strategies, the learning (and begging) curve will continue to be steep.

Perhaps antidepressants are an initial stop-gap while the body of evidence supporting alternatives like acupuncture or isoflavones for hot flashes and depression grows. I’m optimistic we’ll get there. And I will always be happy to see women provided with an alternative to HRT.

Monday A-Musings…It’s a pillow. No. It’s Chillow!

Posted by Liz on Dec 20, 2010 in hot flash | 2 comments

Newsflash: hot flashes and soy…more on genistein

Posted by Liz on Dec 17, 2010 in hot flash | 0 comments

There’s some exciting news on the soy isoflavones front: for the first time, researchers have shown that a synthetic formulation of genistein, a plant-based estrogen component of soy, may actually reduce both the frequency and severity of hot flashes. Genistein is an interesting isoflavone, in that studies have linked it to some truly potentially important benefits, including preventing or reducing heart disease risk and attenuating bone loss in menopausal women. While the verdict is still out on its role in these conditions, it does appear to influence hot flashes and only in the best way possible! Moreover, this is the first time that a synthetic formulation has shown to have some degree of benefit in this regard.

Granted, this is a small study of only 84 menopausal women, 40 of whom took synthetic genistein for 12 weeks and 40 who took a sugar placebo tablet. The results? By the study’s end, women taking 1, 30-mg capsule daily reduced the number of hot flashes by half (51%, from about 10 per day to 5 per day) and also experienced significant declines in how long they lasted. The synthetic formulation, which was standardized, was also shown to be safe and did not detrimentallly impact the lining of the uterus. Notably, however, the researchers did note that there are not enough data to recommend isoflavones to women who’ve had breast cancer or at high risk for developing, even though current data suggest that exposure does not adversely affect breast tissue density or cancer cell proliferation, meaning that it is likely that with more study, they will ultimately prove safe for use in breast cancer patients.

Your key take-away is that there may be a viable option for women who are flashing but want to stay away from hormones. However, this is what we still need to know:

• Will genistein work on larger groups of menopausal women?
• Is formulation important?
• Is the 30 mg dose the lowest dose that will confer these sort of benefits?
• Are there any other factors that these women had in common that might be influencing outcomes?

As with any novel data like these, it’s great to be cautiously enthusiastic. Stay tuned!

Futuristic Monday: hot AND cold creature comforts

Posted by Liz on Oct 11, 2010 in hot flash, menopause, musings | 1 comment

True confession: I love heated car seats. My last boyfriend won my heart with his heated car seats (okay, not really, but it helped!). For me, heated car seats represent the gold ring of driving comfort, especially when the weather is cold or damp and nasty. Consequently, I was intrigued by a call I received last week from a friend of mine who, like me, is contending with a few menopausal symptoms. The call was car seats for the menopausal set.

“Got a sec?” she asked. “I was just driving down to the road and started thinking about heated car seats. The biggest problem,” she explained,” is that they are only designed with one thing in mind: heat.” (Hence their name, but that’s besides the point.) “Why don’t they make car seats that can heat or cool, depending on the temperature (or temprament) of the passenger? ”

Hmmm, sort of like cleavage coolers but for your derriere. Got me thinking and looking around the interwebz. And what I discovered is that the future is now.  In fact, cooled seats are often part of optional packages in a variety of premium and luxury cars with leather upholstery. Experts recommend that you test drive them yourself, since some come with a ventilation system while others actually have separate cooling elements.

If all else fails, there’s always the ‘Amazing SummerSeat Self-Cooling Car Seat Cushion’ (can’t make this stuff up)!

Ladies, when those internal fires get burning, it’s okay to start your engines in comfort.

Be still my heart. I think I’ve just fallen in love again.

Wednesday Bubble: News Flash – there’s a new kid in town

Posted by Liz on Sep 29, 2010 in hot flash, new approaches | 0 comments

[youtube=http://www.youtube.com/watch?v=s6FsnmaJrQQ]

Hey Ladies:

There’s a new kid in town: Menerba®. Although it’s not yet available, the Food & Drug Administration has cleared the way for its manufacturing and production.

Menerba is characterized as an oral botanical drug because its activities are derived from botanical sources, implying that although it is is a pharmaceutical agent, it acts like a plant-based formulation.  Nevertheless, Menerba, which is a selective estrogen receptor modulator (or SERM) is apparently a safe alternative to both selective and non-selective SERMS, as well as HRT, for the treatment of hot flashes/vasomotor symptoms associated with menopause. The reason it is considered an alternative is that unlike traditional SERMS, which activate estrogen pathways that have been implicated in breast and uterine cancers, Menerba specifically targets the estrogen pathway in the body that is directly associated with hot flashes. So, theoretically it should be equally if not more effective for addressing hot flashes and also, safer than agents that have come before it.

Thus far, Menerba has been shown in clinical studies to reduce hot flash frequency by as much as 50% and also significantly improve sleep disruptions due to night sweats, with higher doses yielding the best results. Generally, it is well tolerated  and has not had any noted impact on uterine or breast tissue. A larger trial of 600 postmenopausal women is slated to begin this year and is currently recruiting.

The bottom line?

Menerba looks pretty promising. I’m not quite sold on the characterization of Menerba as a botanical and would like to see more information on this, especially because its characterization as such could certainly be confusing once clinical trials are completed and the drug reaches the market. Nevertheless, you may want to keep an eye out for this new kid in town.