Maria Hasan.
Non-hormonal options for the management of hot flushes: An evidence based solution.
Med Today Jan ;4(3):111-5.

Literature search was carried out to answer the following questions: What are the alternative treatment options for management of hot flushes? What is the evidence regarding their efficacy? SEARCH METHODOLOGY: PubMed, Medline and Cochrane database were searched using the key words hot flush, hot flash, vasomotor symptoms and alternative or non hormonal treatment. There were around 1446 articles when key words “hot flushes and treatment” were used. The search was then narrowed down to 118 articles by adding word “non-hormonal”. Out of which, few articles were chosen that were more pertinent to the clinical questions. CONCLUSIONS: The SSRIs or SNRIs, clonidine and gabapentin trials provide supportive evidence for efficacy in terms of reduction in the frequency and severity of menopausal hot flushes. Effects are less than those for estrogen as showed by the fact that comparison of SSRIs or SNRIs with placebo show significant reductions in hot flushes frequency of approximately one hot flush episode/day. Meta-analysis of similarly designed RCTs of estrogen indicated reductions of approx. 2.5 to 3 hot flushes episodes per day. The trials do not support the efficacy of soy isoflavone extracts. Furthermore, soy foods, isoflavone and black cohosh all appear to have potential estrogenic effects on the breast thus are not recommended in breast cancer patients or in women at high risk for breast cancer. RECOMMENDATIONS The treatment of hot flushes depends upon the frequency and severity of hot flushes along with its effect on the quality of life. No treatment is required unless the hot flushes are bothersome to the woman.

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