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Hot Flashes: Possible Causes and Possible Treatments: Editorial

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Hot flashes are a common problem in many women. Although hormonal treatments, some newer antidepressants, gabapentin, and clonidine have been shown to decrease hot flashes,(1-4), improved treatment options are needed to provide substantial relief without unwanted risks or side effects. A better understanding of the physiology and measurement of hot flashes would expedite the development and testing of more effective treatment options.

Hot Flash Physiology

With regard to hot flash physiology, the article by Carpenter et al (5) in the current issue of Menopause looks at the question of whether tryptophan depletion, resulting in decreased serotonin, would cause increased hot flashes. The

authors’ innovative hypothesis was not supported by the results of this study.

Nonetheless, there was a study limitation that did not allow the authors to disprove their prestudy hypothesis. The study limitation was that, in the control arm of this trial, participants also experienced some tryptophan depletion.

Although the tryptophan depletion in the control arm was to a lesser degree than that seen in the study arm, it was quite marked, with 35% of participants having tryptophan levels less than 10 KM. The authors propose looking at this subject further by studying tryptophan supplementation versus depletion and by potentially adding in the use of a means to induce hot flashes in both groups (such as raising room temperature).

Although the authors proposed that a positive experiment would have supported a mechanism for why selective serotonin reuptake inhibitors or serotonin norepinephrine reuptake inhibitors decrease hot flashes, the negative results
from their trial neither prove nor disprove whether some of these antidepressants decrease hot flashes.

A recent metaanalysis does demonstrate that some of these drugs do moderately decrease hot flashes.3 Furthermore, the antidepressant agents demonstrated to be effective do modulate serotonin in some way, whereas antidepressants found to be
consistent with placebo effects in open-label pilot trials (ie, mirtazapine,6 bupropion,7 and desipramine8) do not impact serotonin.

Add a Comment6 Comments

EmpowHER Guest

Good Info

January 7, 2015 - 11:12pm
EmpowHER Guest

Thanks for the informative article you have provided regarding hot flashes and the after effects. One of my relatives who is having 50 years, was suffering from the hot flashes is searching for a treatment. I am sure this article would be helpful for us.

May 29, 2013 - 10:47pm

Hot flashes are experienced by many women, but not all women undergoing menopause experience hot flashes. A hot flash is a feeling of warmth that spreads over the body, but is often most strongly felt in the head and neck regions. Hot flashes may be accompanied by perspiration or flushing. Hot flashes usually last from 30 seconds to several minutes. Although the exact cause of hot flashes is not fully understood, hot flashes are thought to be due to a combination of hormonal and biochemical fluctuations brought on by declining estrogen levels.
Menopausal symptoms can be caused due to Lower level of estrogen and progesterone. But estrovera might be help you to solve all the menopausal issues like vaginal discomfort, hot flashes, loss of libido, mood swings, insomnia, weight gain and more.

March 12, 2013 - 2:52am
EmpowHER Guest

Don't overlook the power of food to help with hot flashes -- everything from strawberries to garlic! http://www.womentowomen.com/menopause/hotflashesnutritionalrelief.aspx

Women to Women Contributor

October 9, 2012 - 8:36am
EmpowHER Guest

Some natural herbs and supplements help women with hot flashes. Black cohosh, dong quai, flaxseeds and soy can be quite beneficial.

:) Elizabeth


September 24, 2009 - 8:42am

I had 50+ hot flashes a day. My doc put me on an adrenal support supplement (all natural). I don't feel that hot flashes need to be addressed with drugs, there are natural alternatives that are effective. I get no side effects and have not hot flashed since I started taking the supplements regularly.

From how it was explained to me, since I wore down my adrenals living a stressful life, I needed supplementation to build back up my adrenals. I reduced my stress and started doing yoga as well.

Hot Flashes are your bodys way of trying to regulate it's temperature, that's where the adrenals come in... when those are not working properly.. your body can't regulate.

September 21, 2009 - 7:08am
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We value and respect our HERWriters' experiences, but everyone is different. Many of our writers are speaking from personal experience, and what's worked for them may not work for you. Their articles are not a substitute for medical advice, although we hope you can gain knowledge from their insight.


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