Natural Remedies for Hot Flushes

Hot Flash Remedy report

Heres what youll discover in The Hot Flash Remedy report: The herb from central Asia that can stop hot flashes in one week! (page 17) How your brain gets tricked into firing up the furnace and how to recalibrate it. (page 6) 7 lifestyle factors that increase your odds of suffering from hot flashes. (page 19) 9 food items that bring hot flashes on fast and furious! (page 10) The bean that actually makes hot flashes non-existent for women in other countries. (page 12) The secret ingredient in your fruit bowl that extinguishes the flame. (page 17) Why 6 meals a day are better than 3 and eating more often wont make you gain weight! (page 10) How common wildflowers hold the key to shutting down hot flashes. (page 16)

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Diet as therapy Menopausal symptom control

With fewer women taking hormone replacement therapy due to recent evidence, more women are looking for alternatives to control menopausal symptoms, particularly hot flushes. Several possibilities have been promoted for this, with a variety of depth of evidence. Soy products contain estrogen-like compounds called isoflavones. These are converted in the liver to substances similar to selective estrogen receptor modulators (SERMs) and have both agonist and antagonist activity at estrogen receptors. Intake of soy protein may therefore be helpful in the short-term (two years or less) treatment of hot flushes associated with menopause (evidence level C). Soy intake in the longer term may reduce serum cholesterol and protect against osteoporosis (evidence level C). Dietary soy intake may differ in biological activity from isoflavones in supplements (Table 3.2).2,3

Hormonal fluctuations

An interview survey of 124 perimenopausal women found that the age group centering around 49 years did not have sexual difficulties in desire, response, or satisfaction in their sexual life, whereas a subset of women with very low estradiol levels tended to have reduced coital activity.19 In a study of 43 perimenopausal women who kept daily records of menstrual cycles and sexual activity, a negative association was found between hot flush ratings and regularity of sexual intercourse at both time points. Frequency of sexual intercourse and level of plasma estradiol were higher, and hot flush ratings were lower in early perimenopausal women who were still having cycles at least once every 30 days, as compared with late perimenopausal women who were cycling less often. A close association exists between increasing irregularity of menstrual cycles, hot flushes, declining estradiol levels, and declining frequency of intercourse during the perimenopause.20

The Side Effects of Hormonal Therapy

As time has progressed, the GnRH agonists have also been shown to have side effects. These include memory loss, parkin-sonism, anemia, and osteoporosis, in addition to the hot flushes and impotence that were obvious from their first use. The most important of the side effects physiologically is osteoporosis, with a loss of bone mass of nearly 10 per annum. Although bispho-sphonates have been shown to be of little effect in prostate cancer in terms of limiting pain and tumor progression, which are the main benefits of their use in breast cancer and myeloma, this group of agents is of significant use in limiting osteoporosis in prostate cancer 11 .

Combined Radiotherapy and Hormone Therapy

The potential benefits of androgen deprivation have to be balanced against toxicity. Most patients experience hot flushes, fatigue, and impotence of varying degrees, which can impact significantly on quality of life. Other toxicities include loss of libido, weight gain, muscle wasting, and changes in texture of hair and skin. Longer-term concerns include the development of osteoporosis and the possibility that low testosterone levels may predispose to cardiovascular disease. There is no evidence yet that long-term hormone therapy increases non-prostate cancer mortality, but this is being investigated in the meantime, it is sensible to restrict the use of long-term hormone therapy to patient groups in which it has been shown to have an overall survival benefit.

Is the Case for Immediate Treatment Proved

On the other hand, are there problems with immediate treatment The immediate side effects of impotence, hot flushes, and so on have been long recognized. However, just as studies have started to show that clear benefits may result from immediate treatment, so has the possibility emerged that serious harmful effects may result from androgen treatment. Some of these are specific to particular therapies, such as cardiovascular complications of estrogens, and liver toxicity of antiandrogens. However, testosterone deficiency, including androgen deprivation from orchiectomy or LHRH analogues, long considered safe options, is now recognized to cause weight increase, loss of muscle mass, and loss of energy 26 . Anemia may be a particular problem in patients treated with combined androgen blockade 27 . Osteoporosis has been

CIntroduction of Contrast Medium and Radiography

(2) The pertinent aspects of the procedure should be explained to the patient, and he should be warned about the sensations he is likely to experience during the procedure (such as hot flashes, gagging, and nausea). The necessity for controlling respiratory or bodily movements during the exposure of the films should be stressed.

The choice to use hormoneestrogen therapy

ET markedly improves menopause-related symptoms, such as hot flushes, hot disordered sleep, and vaginal dryness. Quality of life improves in the subset of women who use ETfor amelioration of hot flushes and disordered sleep.54 Menopausal symptoms, such as vasomotor symptoms (hot flushes) and urogenital symptoms black cohosh and antidepressants on hot flushes

Types of estrogenprogestin therapy and estrogenalone therapy

All forms of estrogen are equivalent in treating menopausal symptoms such as hot flushes and vaginal dryness. Oral estrogens generally improve lipid panels favorably, particularly by increasing the high-density lipoprotein (HDL) cholesterol. In some women, however, oral estrogens may raise serum triglyceride levels. Vaginal estrogens, which generally result in lower levels of circulating hormone, do not protect against bone loss, improve lipids, or impact hot flushes. At first, they are usually used nightly for one to two weeks, after which

Herbal preparations black cohosh

The German Commission E Monographs report that black cohosh has estrogen-like actions, suppresses LH, binds to estrogen receptors, and lacks contraindications to its use. Side effects include gastric discomfort, sweating, weight gain, and headache. A six-month trial funded by the manufacturer of one black cohosh product reported that women benefited from a 70 reduction in symptoms such as hot flushes, mood swings, night sweats, and insomnia. Higher doses did not improve symptoms.70

The Menopausal Transition

Menopause signals the end of child-bearing capacity, and is also associated with changes in susceptibility to various chronic diseases, including breast cancer, heart disease, and osteoporosis.66 Differences in age at menopause between vegetarian and omnivorous women, should they exist, could be associated with differences in chronic disease patterns between these groups. Furthermore, some women experience unpleasant symptoms during menopause (vasomotor symptoms such as night sweats and hot flushes, mood swings, insomnia, weight gain, headaches, and fatigue),67 and these symptoms have been observed to differ among women in different cultures.67,68 Whether dietary variables contribute to these differences in symptom experiences has not been clearly established, but there is speculation that they could.68-70 Some of these dietary differences may also exist between vegetarian and omnivorous women. Accordingly, after defining and describing the menopausal transition, available research on...

Modification of Genetic Risk Caused by Environmental Factors

Believed the drugs caused a slightly elevated risk of breast cancer after long-term use, but conferred protection against cardiovascular disease (heart attacks, strokes, thromboses) and prevented osteoporosis, the thinning of bones that lead to fractures. HRT was known to prevent uncomfortable symptoms of menopause such as hot flashes, night sweats, mood swings, and vaginal dryness.

Items 738 through 741

A 52-year-old woman presents to your office for her annual gynecological examination. She stopped menstruating about 6 mo ago and is getting some hot flashes. Her history reveals that she drinks one glass of wine per day and smokes about 10 cigarettes per day. She does not exercise much and is overweight. Her most important risk factor for developing osteoporosis is

Selective estrogen receptor modulators

Raloxifene therapy results in decreased serum total and low-density lipoprotein (LDL) cholesterol without any beneficial effects on serum total high-density lipoprotein (HDL) cholesterol or triglycerides.41,42 The side effects of raloxifene are vaginitis and hot flushes.43 Investigators in the Multiple Outcomes of Raloxifene (MORE) trial of more than 7000 postmenopausal, osteoporotic women over three years showed a decreased breast cancer risk in those already at low risk for the disease.44 The study results were analyzed separately for women presenting with pre-existing fracture. While treatment effectiveness was similar in both groups, the absolute risk of fractures in the group with

Complementary and alternative therapies

A topical form of natural progesterone derived from diosgenin, which occurs in soybeans and Mexican wild yams, has been promoted as a treatment for osteoporosis, hot flushes, and premenstrual syndrome, and as a prophylactic against breast cancer. However, eating or applying wild yam extract or diosgenin does not produce increased progesterone levels in humans because humans cannot convert diosgenin into progesterone.45

Obstetrics and Gynecology

The answer is b. (Fauci, 14 e, p 2102.) The patient is presenting with symptoms of normal menopause, which may include hot flashes, urinary frequency, dysuria, urinary incontinence, vaginal dryness, vaginal itchiness, and dyspareunia. Patients also have amenorrhea. Patients may become anxious or depressed during this time, but there is no evidence that personality or mood changes are due to menopause.

Perimenopause and menopause

This transition is caused by a decrease in gonadotropin and ovarian hormones. The ovaries produce decreasing amounts of estrogen and the target organs become less sensitive. Some women experience significant symptomatology during this time, which leads them to seek medical assistance. Menstrual changes, hot flushes, and other signs of estrogen deficiency, such as vaginal dryness, maybe the first symptoms that a woman experiences. Perimenopause is a transition phase that usually lasts four to six years. This is the time when women move from a state of fertility and potential childbearing to infertility and permanent amenorrhea. Vasomotor symptoms, described as hot flushes and cold sweats, are often the most disruptive perimenopausal symptoms that a woman experiences. These symptoms can occur even before any changes in menstrual pattern. There is significant variation in an individual woman's response to these, and the symptoms can be distracting, cause insomnia, and lead to unpleasant...

Psychological aspects of menopause Menopause as a transition

Additionally, cross-cultural studies reveal considerable differences in reporting ofvasomotor symptoms, such as hot flushes. Japanese women report significantly fewer hot flushes than North American and European counterparts.45 Mayan women essentially report no menopausal symptoms, except for menstrual irregularities.46 While cultural perceptions of menopause may modify evaluation of physical changes and symptoms, lifestyle and dietary changes may also play a part. Considerable differences in hot-flush reporting exist even within a culture, with wide variations with location intensity, and duration of flushes.47 Positive correlation has also been found between hot-flush frequency and higher levels of perceived stress.48

Alternatives to hormone therapy including complementary treatments

Hot flushes Although over 85 of women experience hot flushes, most women find that their symptoms resolve or improve over two to five years. More than 30 of women use complementary and alternative measures, such as acupuncture, natural estrogen, herbal supplements, and plant estrogens to control symptoms. Most studies of menopausal interventions demonstrate a 20-30 improvement in the symptoms of the placebo groups regardless of whatever method is chosen for the intervention.63 This high rate of resolution of symptoms makes it imperative that methods that purport benefit be subjected to careful scrutiny. VTE, MI, stroke, hot flushes, endometrial cancer risk with tamoxifen Hot flushes Tibolone comparable benefit to HRT Venlafaxine 37.5-150 mg per day (decreased hot flushes in 37-61 higher doses worked better but also associated with greater likelihood of adverse effects) Megestrol acetate 20 mg bid decreased hot flushes from 5 to 21 compared with placebo Data from Kronenberg, F. and...

Normal healthy diet

Case S.K. is a generally healthy 49-year-old woman who presents for a routine annual exam. She complains of occasional hot flushes and asks what she can do about them without taking hormones. She also has a family history of cancer in several relatives, so she wants to know what she should do with her diet to stay healthy.

Developmental tasks

Case a 54-year-old woman presents with a nine-month history of amenorrhea, hot flushes, difficulty sleeping, and edgy mood. She reports that her mother, sisters, and friends have shared with her how difficult going through the change had been for them. She has read about recent study results raising concerns regarding hormone replacement therapy and cardiovascular risks, but she has also heard that hormones can help to reduce the signs of aging. She is divorced and had launched her final child from home this past summer. She has enjoyed rearranging the house but is not sure how she will spend her time as she gets closer to finishing this project.

Kathy Andolsek

Case a 51-year-old healthy woman presents to the office. She has two children, 24 and 21 years of age, both delivered by cesarean section for fetal distress. Following the second delivery, she had a bilateral tubal ligation for contraception. She has had no other medical conditions. She reports that her menses have changed over the past year, becoming shorter and lighter. She occasionally skips a period altogether. She reports hot flushes, palpitations, and some sleep disruption. She believes that the sleep disruption has led to fatigue and some mild cognitive changes, which are beginning to interfere with her work performance. She has no personal or family history of breast cancer, coronary artery disease, or thromboembolic disease. She does have a family history of osteoporosis. She is a non-smoker, drinks two beers weekly, and exercises inconsistently. Her best friend had been on hormone therapy but stopped with the recent news concerning adverse effects. She wants to know whether...

Hormones

Estrogens certainly improve hot flushes.64 Doses as low as 20 mg transdermal estrogen have been demonstrated to reduce the severity of symptoms. HT should be used only if menopausal symptoms are troublesome, alternatives are not acceptable or effective, and the woman is informed fully of the risks. prescribed. Short-term use of HT ET maybe a reasonable option, since hot flushes, for instance, tend to decrease in most women after three to five years. Progestin alone also improves hot flushes.65 Testosterone may improve symptoms as well but is not approved for use in women except in combination with estrogen.

Tibolone

Tibolone is a steroid compound with estrogenic, progestogenic, and androgenic properties.66 It is effective for reducing the frequency and severity of hot flushes and improving vaginal dryness and libido. Tibolone has been shown to increase bone mineral density, with little effect on the breast or endometrium. It should not be used in women with a history of coronary artery disease, stroke, or liver disorders. Caution is also advisable in women with kidney disease, epilepsy, migraine, diabetes, and high cholesterol. Tibolone may interact with some drugs, including anticoagulants. Its androgenic properties may cause oily skin and extra hair growth. Breast symptoms are rare. It is not available in the USA.

Phytoestrogens

Populations that consume high levels of dietary isoflavones report fewer hot flushes. Asian diets, for example, contain 40-80 mg active forms of isoflavones daily. However, other differences in Asian women, such as cultural factors, body mass index, and exercise patterns, may be responsible for this.

Testosterone

There are no data to suggest that women benefit from routine supplementation with testosterone.82 A few early studies suggested that testosterone improved women's sexual function but also caused significant adverse effects, such as acne, excess facial and body hair, and abnormal lipid levels. Testosterone may improve hot flushes in women whose symptoms are resistant to estrogen or estrogen progestin. A combination of estrogen and methyl testosterone is available for the treatment of resistant hot flushes, but it has not been approved for the treatment of sexual dysfunction.

Menopause

Women usually stop menstruating at about the age of 45. This is known as the menopause. At this time, nearly all the primary follicles in the ovaries have been released or have become involuted (returned to normal size). Since the primary follicles supply most of the body's estrogen, the cyclic increase and decrease of estrogens cannot occur. Thus, the menstrual cycle is ended. Some women experience various effects (for example, hot flashes, fatigue, anxiety, and irritability) because of the metabolic changes the body is undergoing because of the decreased production of estrogen. The physician may prescribe estrogen therapy to the woman during this time.

Items 388390

A 51-year-old G3P3 presents to your office with a 6-month history of amenorrhea. She complains of debilitating hot flashes that awaken her at night she wakes up the next day feeling exhausted and irritable. She tells you she has tried herbal supplements for her hot flashes, but nothing has worked. She is interested in beginning hormone replacement therapy, but is hesitant to do so because of its possible risks and side effects. The patient is very healthy. She denies any medical problems and is not taking any medication except calcium supplements. She has a family history of osteoporosis. Her height is 5 ft, 5 in. and her weight is 115 lb. 390. All of the following statements about hot flashes are accurate except a. Hot flushes usually resolve spontaneously within 2 to 3 years b. Hot flushes usually last less than 3 min c. When HRT is initiated as a treatment for vasomotor symptoms, hot flushes usually resolve within 1 week d. Hot flushes can begin several years before actual...

Items 367369

A 53-year-old woman presents to your office with questions about hormonal replacement therapy (HRT). She has been experiencing hot flashes and night sweats. She has not menstruated for one year. She has no risk factors for cardiovascular disease. She is 5'6 and weighs 120 lbs. Her gynecological examination is normal as well as her Pap smear. Her breast examination and mam-mography are also normal. She wonders about the risks and benefits of HRT given her health status.

Items 322323

A 5 2-year-old woman presents to your office for her annual gynecological examination. She stopped menstruating about 6 months ago and is getting some hot flashes. Her history reveals that she drinks one glass of wine per day and smokes about 10 cigarettes per day. She does not exercise much and is overweight. Her most important risk factor for developing osteoporosis is