So, you have reached a new stage of life- you are suddenly feeling very flushed in work meetings, tossing and turning at night since the temperature is never right, waking up drenched, and are wide awake from 1:00-3:00 AM. Over 80% of women experience vasomotor symptoms, known as hot flashes and night sweats. These symptoms can start years before periods start to space out and can continue even after menopause, when you haven’t had a period for over a year.
Eating a balanced diet, getting adequate exercise, and having a good bedtime routine is always important. Evidence has shown that cognitive behavioral therapy and clinical hypnosis can be beneficial. More information on lifestyle recommendations can be found here: https://womenswellnesscentermd.com/non-hormonal-treatment-of-hot-flashes/
But maybe you’ve optimized your lifestyle and still need additional support. Women may choose to use hormone therapy (HT) to treat their symptoms, but for those who cannot because of medical conditions (such as breast cancer or a history of heart attack, stroke, or blood clot) or for those who choose not to use HT, there are several non–hormonal medications we can use to manage perimenopause and menopause symptoms.
- The FDA has approved an antidepressant, called Paroxetine, for hot flashes, night sweats, and resulting sleep disturbances. We use this at low doses and find that it can also help with mood changes in the menopause transition. Paroxteine can take up to 1 month to see the full effect.
- The other FDA approved medication is called Fezolinetant or Veozah. Veozah targets the center in the brain that is responsible for hot flashes and night sweats. This medication can transiently increase your liver enzymes, so blood monitoring is needed. Studies have shown reduced symptoms by 4-12 weeks on Veozah.
- While not FDA approved, we also find that Gabapentin can reduce hot flashes and night sweats. Since drowsiness is a side effect of gabapentin, this is a medication we use at bedtime. Symptom relief is often achieved in 2 weeks.
- Oxybutynin is another medication that has been shown to reduce hot flashes and night sweats, while also helping urinary symptoms. Side effects can include dry mouth and urinary difficulties. Full effect can be seen in 3 months.
These symptoms can have a significant effect on quality of life. They may be interfering with your relationships, performance at work, or psychological well-being. Book a consultation to discuss your treatment options today! Kaelen Clark, NP, MSCP (Menopause Society Certified Practitioner.