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Menopause and Sweating

Menopause and Excessive Sweating: When Medication Is in Order

Some women find relief with lifestyle changes, but others need more. The most important thing to remember: talk to your doctor and think about all of the possibilities for treatment, says Mary Lake Polan, MD, PhD, adjunct professor of obstetrics and gynecology at Columbia University School of Medicine in New York City.

Finding a treatment that works for you is a highly individual thing. “I tell patients to keep trying,” Polan says. Sooner or later you’ll find relief from hot flashes and night sweats.

Hormone therapy. Hormone therapy is the most effective way to treat hot flashes, but the Women's Health Initiative study found an increased risk for heart disease, blood clots, and stroke, and an increase in breast cancer when women took oral estrogen and progestin long-term, Omicioli says. The increased heart disease risk was in older women who were 10 or more years postmenopausal, she says.

But there’s emerging evidence that non-oral forms of estrogen -- a cream, gel, patch, or ring -- may have safety advantages in reducing risk of blood clots and stroke, Omicioli says.

The WHI study didn’t find an increased risk of breast cancer in women who took estrogen alone, Omicioli says. The study also looked at one dose of oral estrogen and synthetic progestin. “There may be a lower risk with progesterone vs. synthetic progestin,” she says.

The benefits and risks should be weighed with your doctor. If you decide to choose hormone therapy, the FDA recommends taking low-dose hormones for the shortest time consistent with treatment goals.

Other options. If hormones aren’t an option, there are other treatments that may help. Studies have found that antidepressants called selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) may improve hot flashes. These medications work for hot flashes at a slightly lower dose than if you were taking them for depression, Polan says.

Gabapentin (Neurontin), and anti-seizure medication, and clonidine (Catapres), used to treat high blood pressure, are also sometimes prescribed for hot flashes.

The supplement black cohosh may also help some women reduce hot flashes, although the results of scientific studies have been mixed.

For other supplements, including DHEA, dong quai, ginseng, kava, red clover, and soy, there's no conclusive evidence that they help manage menopausal symptoms. Research into the safety and effectiveness of supplements is ongoing. Because supplements can cause side effects and interact with medications, it is important to talk to your doctor if you are thinking about using them.

Whether your hot flashes are mild, moderate, or severe, there is help. Dolgen recommends going to a menopause specialist, which is what helped her finally find relief.

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Reviewed on July 20, 2011

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