A double blind study to evaluate the effect of methyldopa on menopausal vasomotor flushes

Vasomotor flush (VMF) is the most consistent symptom associated with the menopause. Nonsteroidal agents such as clonidine have been demonstrated to decrease VMF. Anecdotal reports suggested that VMF were reduced in hypertensive women receiving methyldopa, which is also an alpha2-adrenergic agonist. This study describes a double-blind cross-over placebo-controlled study to evaluate the effect of methyldopa on VMF. Diary reports were made and serum LH and digital skin temperature were measured in 10 menopausal women with 30 or more VMF/week and serum FSH levels of 40 mIU/ml or greater. The frequency of VMF, LH pulse, and temperature elevation during a 5-h observation period and VMF per week based on diary reports were compared for the baseline and fourth week of therapy with methyldopa (250 mg, three times daily) and placebo therapy. The patients reported some amelioration of VMF (P less than or equal to 0.02) during drug therapy. Objectively, only the frequency of LH peaks was decreased with methyldopa therapy (P less than or equal to 0.05). Because of significant side effects and minimal symptomatic improvement, methyldopa is not likely to be an acceptable therapy for VMF.