WOMENS-HEALTH Messages for June, 1997: Re: Hot flashes....

Re: Hot flashes....

From: Catalin (anonymous@obgyn.net)
Sun, 1 Jun 1997 17:10:10 +0300 (GMT+0300)

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Reply: Laurie: "Re: Hot flashes...."

On Wed, 28 May 1997, Laurie Lovely wrote:

> At Tue, 27 May 1997, Beth wrote:
> >
> >These hot flashes are driving me crazy. Numerous during both day and
> >night. Any suggestions other than HRT which is out of the question
> >right now..Thanks....
>
> I don't know what part of HRT is out of the question for you--if you can
> take the progestin part, that alone is effective in relieving hot
> flashes. Clonidine, an antihypertensive medicine that affects the blood
> vessels, is also effective. It's available as a patch or pills.
> Bellergal is a tablet containing belladonna derivative and phenobarbital
> derivative--in most studies it's no more effective than placebo, but it
> does have sedative properties and may help those affected primarily
> during the night. Ginseng tea has been studied and is known to decrease
> the frequency of hot flushes, though not eliminate them entirely. I
> have had patients tell me they swear by evening primrose oil, but have
> not seen studies on this subject. Dietary tofu, which contains plant
> estrogens, can also have mild effects.
>

>From the above mentioned "drugs", I have experience with only clonidine
(0.05 mg bid) and I used it *only* in patients with flushes due to rosacea.

Some authorities consider clonidine to be effective in controlling flushes (due to an alpha-adrenergic vasoconstrictive effect on the facial veins). However, from my personal experience, I found it not effective in controlling flushes (and there are also some RCTs which found clonidine not better than placebo).

Regarding the topical form of clonidine (2% cream), there is a study published in Br Med J, in which the authors found it completely uneffective in 20 patients with flushes and rosacea. (I hadn't the chance to try it, as it isn't available here.)

I'd like to hear which is, in your oppinion, the most effective way to treat flushes. This was and remains an important challenge for us, the dermatologists, and I feel that we haven't found yet the "magic bullet".

> Good luck finding relief. Do you mind if I ask why HRT is out right
> now?
>
> --
> Laurie Lovely, MD
> RE fellow, UNC-Chapel Hill
>

--
Catalin Popescu
Dermatologist
Bucharest, Romania

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