Testing Treatment for Hot Flashes

(September 18, 2008) - Women troubled by hot flashes and night sweats during the years around menopause (Read about "Menopause") want safe, effective treatment options. A new research initiative from the National Institutes of Health (NIH) will establish a multisite research network to conduct clinical trials of promising treatments for the most common symptoms of the menopausal transition.

"Studies such as the Women's Health Initiative, which raised concerns about the safety of using menopausal hormone therapy, underscore the urgent need for treatments that have been proven safe and effective for alleviating menopausal symptoms," said National Institute on Aging (NIA) Director Richard J. Hodes, MD.

Researchers will conduct randomized clinical trials to test a variety of approaches for treating menopausal symptoms. "Different approaches will be studied for efficacy against hot flashes and night sweats in diverse groups of women in trials with either placebo or usual-care control groups. Investigators will also look at possible effects on other symptoms at middle age, including sleep disturbance, mood disorder, vaginal dryness and sexual function," said Judy Hannah, program official from the NIA's Division of Geriatrics and Clinical Gerontology.

A number of different treatment strategies are under consideration. Possible treatments to be studied during the five-year project period include:

• antidepressants such as paroxetine (Paxil) or escitalopram (Lexapro)
• paced respiration (slow deep breathing also known as relaxation breathing)
• yoga
• low-dose estradiol patch and low-dose estradiol gel
• exercise programs, both moderate and vigorous

Currently, menopausal hormone therapy is still considered the most effective way to control moderate to severe menopausal symptoms such as hot flashes and night sweats. Experts recommend that when it is used, physicians prescribe the lowest effective dose for the shortest period necessary, but some women are reluctant to use menopausal hormone therapy because of possible side effects. Hormone therapy is suspected to increase the risks of breast cancer, stroke and heart disease. (Read about "Breast Cancer" "Stroke" "Coronary Heart Disease") Women can experience menopausal symptoms for several years before menopause - the date of their last menstrual period - and sometimes for many years after. For some women with severe menopausal symptoms, the resulting discomfort can greatly diminish their quality of life.