Fertility Drug May Be New Hot Flash Treatment
Far Fewer Hot Flashes in 3 Women Treated With Cetrotide
Sept. 16, 2009 -- Women suffering from severe postmenopausal hot flashes may
get relief from the fertility drug Cetrotide, a small study suggests.
The three women in the study had their lives disrupted by frequent, severe
hot flashes, says study leader Hans de Boer, MD, PhD, of Rijnstate Hospital in
One developed symptoms after going off hormone therapy. Another was a breast
cancer survivor who underwent treatment with an estrogen-blocking drug. The
third had her ovaries removed during successful treatment for endometrial
"They all responded very well to the treatment," de Boer tells WebMD. "The
woman who had breast cancer treatment had a very large number of hot flashes
and now has only two a day. She has totally changed. She couldn't live her life
before, and now she is a very happy person."
The drug used to treat the women was Cetrotide, a fertility drug. The drug
helps control hormones that tell the ovaries when to release an egg. There are
receptors for the same hormones in the brain cells that control the body's
Cetrotide is given by daily, self-administered, under-the-skin injections.
Two of the women in the study eventually needed two daily doses.
Cetrotide isn't cheap. A single dose costs about $124, although prices vary
from pharmacy to pharmacy. But de Boer says that if clinical trials find the
drug to be a safe and effective treatment for hot flashes, demand may drive the
And clinical trials will be needed. De Boer is quick to note that although
his small study is suggestive, only much larger studies can show whether -- and
how -- Cetrotide can be used to treat hot flashes.
But so far, the treatment seems safe.
"I have not seen any side effects, and I don't expect them," de Boer says.
"It may lower estrogen levels further in postmenopausal women, and this could
possibly have a negative effect on bone mass. But I don't think we'll see much
of this effect because estrogen levels are already so low in postmenopausal
women. And in women treated for breast cancer, it could be an advantage if
estrogen levels decline further."
De Boer says he has no financial interest in Cetrotide, although he says he
is talking to the drug's manufacturer about supporting a placebo-controlled
Not every woman who goes through menopause suffers from hot flashes. But
some women, particularly those thrust into menopause by hormone treatments for
breast cancer, may have their lives disrupted by frequent and severe hot
Hormone therapy helps hot flashes for many women, but not for all who suffer
severe symptoms. And many doctors are reluctant to offer hormone therapy
because of safety concerns.
It's not clear why hot flashes occur, but a hormone called LHRH (luteinizing
hormone-releasing hormone) may be involved. It's thought that LHRH triggers
brain cells that control temperature regulation, tricking the body into
reacting as though it's too hot. Cetrotide blocks the cellular receptor LHRH
uses for cell signaling.
De Boer and colleagues report the findings in the Sept. 17 issue of the
New England Journal of Medicine.