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Making sense of the evidence regarding nonhormonal treatments for hot flashes
Debra Barton1, Charles L Loprinzi
1barton.debra@mayo.edu
Abstract:
The demand for nonhormonal interventions for hot flashes is increasing because of the number of patients diagnosed with hormone-sensitive cancers and the results of the Women's Health Initiative indicating that hormone replacement therapy is not as beneficial as originally believed. Since 2002, numerous studies testing nonhormonal treatments for hot flashes have been conducted. Clinicians need to be able to use these research findings to help patients make treatment decisions. Because hot flashes can interfere with activities of daily living such as sleep and work, clinicians first should assess the extent to which hot flashes are disruptive to a woman's life. The evidence for nonhormonal interventions is summarized, and a decision treatment algorithm is offered for use in clinical practice. This algorithm includes nonhormonal options of the antidepressants available in addition to gabapentin, an antiseizure medication. A short review of the evidence for possible complementary therapies also is included.
Insights
Nonhormonal treatments for hot flashes are increasingly important. This review summarizes evidence for antidepressants and gabapentin to help clinicians manage disruptive hot flashes.
Area of Science:
- Women's Health
- Clinical Therapeutics
- Pharmacology
Background:
- Growing demand for nonhormonal hot flash interventions due to cancer diagnoses and Women's Health Initiative findings.
- Hormone replacement therapy (HRT) is now viewed as less beneficial and carries risks.
- Hot flashes significantly impact daily life, including sleep and work.
Purpose of the Study:
- To summarize evidence for nonhormonal hot flash treatments.
- To provide clinicians with research findings for patient treatment decisions.
- To offer a clinical decision algorithm for managing hot flashes.
Main Methods:
- Systematic review of studies on nonhormonal hot flash interventions published since 2002.
- Evaluation of evidence for specific nonhormonal options, including antidepressants and gabapentin.
- Inclusion of a review of complementary therapies for hot flashes.
Main Results:
- Evidence for nonhormonal interventions is summarized to guide clinical practice.
- A treatment algorithm is proposed, incorporating antidepressants and gabapentin.
- Complementary therapies are briefly reviewed for potential use.
Conclusions:
- Clinicians should assess the disruptive impact of hot flashes on patients' lives.
- Nonhormonal options like antidepressants and gabapentin are viable alternatives to HRT.
- The provided algorithm can aid in selecting appropriate nonhormonal treatments for hot flashes.
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