Q: I'm 65-year-old female. I was diagnosed with a blood clot in my leg while using the hormone patch Alora for hot flashes. I had to stop Alora. The hot flashes came back. I tried gabapentin with no relief. Is there anything I can take to relieve hot flashes? I'd prefer something natural or over-the-counter, but if I had to, I would try another prescription.
A: The number of menopausal hot flashes usually goes down with time. So, one possibility is to wait to see if they improve on their own. While you wait, here are some lifestyle changes to help you cope with the hot flashes:
2. Stay well hydrated, especially with a cool beverage during a hot flash.
3. Start a program of vigorous exercise. Some women find this makes a big difference. Check with your doctor if this is safe for you.
Estrogen is the most effective prescription medicine. It relieves hot flashes in over 90 percent of women who use it. But many women cannot take estrogen because of its side effects. One major one is the formation of blood clots.
Other prescription medicines that can help decrease the frequency and intensity of hot flashes are gabapentin, some antidepressants and progesterone. But none of these is as effective as estrogen. You already tried the gabapentin without success. Talk over the pros and cons of the other drugs with your doctor.
Estrogens derived from plants (phytoestrogens) may help some women with hot flashes, but they have not been proven effective in larger scientific studies.
There have also been claims that other natural products -- such as the herb black cohosh and evening primrose oil -- can help. But these have not shown to be better than a placebo ("sugar pill") in clinical trials.
While most herbal products are likely safe, you can never be sure because they are not tested with the same rigor as prescription drugs. So be cautious if you choose to use these products.
(Joan Bengtson, M.D., is an assistant professor of obstetrics, gynecology and reproductive biology at Harvard Medical School and Brigham and Women's Hospital, Boston, Mass. Dr. Bengtson is a Senior Medical Editor at Harvard Health Publications.)
(For additional consumer health information, please visit http://www.health.harvard.edu.)