Menopausal hot flushes and night sweats: where are we now?
Date
2011
Authors
Archer, D.
Sturdee, D.
Baber, R.
de Villiers, T.
Pines, A.
Freedman, R.
Gompel, A.
Hickey, M.
Hunter, M.
Lobo, R.
Editors
Advisors
Journal Title
Journal ISSN
Volume Title
Type:
Journal article
Citation
Climacteric, 2011; 14(5):515-528
Statement of Responsibility
D. F. Archer, D. W. Sturdee, R. Baber, T. J. de Villiers, A. Pines, R. R. Freedman, A. Gompel, M. Hickey, M. S. Hunter, R. A. Lobo, M. A. Lumsden, A. H. MacLennan, P. Maki, S. Palacios, D. Shah, P. Villaseca and M. Warren
Conference Name
Abstract
Objective: An overview of the current knowledge on the etiology and treatment of vasomotor symptoms in postmenopausal women. Materials and methods: Acknowledged experts in the field contributed a brief assessment of their areas of interest which were combined and edited into the final manuscript. Results: Women around the world experience vasomotor symptoms as they enter and complete the menopause transition. Vasomotor symptoms, specifically hot flushes, are caused by a narrowing of the thermoneutral zone in the brain. This effect, although related to estrogen withdrawal, is most likely related to changes in central nervous system neurotransmitters. Peripheral vascular reactivity is also altered in symptomatic women. Estrogen replacement therapy is the most effective treatment for hot flushes. Of the other interventions investigated, selective serotonin and selective norepinephrine reuptake inhibitors and gabapentin show efficacy greater than placebo. Objective monitoring of hot flushes indicates a robust improvement with hormone replacement therapy but little to no change with placebo. These data suggest that the subjective assessment of responses to therapy for vasomotor symptom results in inaccurate data. Hot flushes have recently been associated with increased cardiovascular risks and a lower incidence of breast cancer, but these data require confirmation. Conclusions: Vasomotor symptoms are experienced by women of all ethnic groups. They are caused by changes in the central nervous system associated with estrogen withdrawal and are best treated with estrogen replacement therapy. Objective monitoring of hot flushes indicates that placebo has little to no effect on their improvement. Subjective assessments of hot flushes in clinical trials may be inaccurate based on objective measurement of the frequency of hot flushes. Based on preliminary reports, women experiencing hot flushes have an increased risk of cardiovascular disease and a reduced incidence of breast cancer.
School/Discipline
Dissertation Note
Provenance
Description
Access Status
Rights
© 2011 International Menopause Society