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Menopausal hot flushes and night sweats: where are we now?

Archer, D F and Sturdee, D W and Baber, R and de Villiers, T J and Pines, A and Freedman, R R and Gompel, A and Hickey, M and Hunter, M S and Lobo, R A and Lumsden, M A and MacLennan, A H and Maki, P and Palacios, S and Shah, D and Villaseca, P and Warren, M (2011) Menopausal hot flushes and night sweats: where are we now? Climacteric : the journal of the International Menopause Society, 14 (5). pp. 515-28. ISSN 1473-0804. This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids

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Official URL: http://informahealthcare.com/doi/abs/10.3109/13697...

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.

Item Type: Article
Additional Information: This article is accessible to all HEFT staff and students via NHS Evidence www.evidence.nhs.uk by using their HEFT Athens login Ids
Subjects: WP Gynaecology. Women’s health
Divisions: Womens and Childrens
Related URLs:
Depositing User: Sophie Rollason
Date Deposited: 27 Jun 2014 09:42
Last Modified: 27 Jun 2014 09:42
URI: http://www.repository.heartofengland.nhs.uk/id/eprint/379

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