Continuous transdermal nitroglycerin therapy for menopausal hot flashes: a single-arm, dose-escalation trial

Area of Science:

• Reproductive Medicine
• Pharmacology

Background:

• Hot flashes are a common symptom for perimenopausal and postmenopausal women.
• Current treatments for hot flashes may have limitations or side effects.

Purpose of the Study:

• To evaluate the efficacy and tolerability of continuous transdermal nitroglycerin for managing hot flashes.
• To assess the impact of nitroglycerin on hot flash frequency and severity.

Main Methods:

• A single-arm, dose-escalation trial involving 19 perimenopausal and postmenopausal women with frequent hot flashes.
• Participants applied transdermal nitroglycerin patches daily, escalating dosage weekly up to 0.6 mg/hour as tolerated.
• Hot flash frequency and severity were recorded in symptom diaries over 4 weeks, followed by a discontinuation week.

Main Results:

• A significant reduction in daily hot flash frequency (54%) and moderate-to-severe hot flashes (69%) was observed at maximum nitroglycerin dosage compared to baseline (P < 0.001).
• Upon discontinuation, hot flash frequency increased by 23% and moderate-to-severe hot flashes by 96% (P < 0.001).
• Most participants tolerated dose escalation, with two discontinuing early due to unspecified reasons.

Conclusions:

• Continuous transdermal nitroglycerin demonstrated substantial and reversible decreases in hot flash frequency and severity.
• Nitroglycerin may represent a novel nonhormonal treatment option for hot flashes.
• Further confirmation in a randomized blinded trial is warranted.