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Change in Estrogen Treatment for Hot Flashes

Review on October 23, 2009

For women who experience hot flashes due to menopause, it is not uncommon to try whatever approach is believed to provide relief for said symptom. Many women, prior to 2003, were avid users of estrogen for relief from hot flashes. This rising trend of hormone therapy declined however after a 2002 report, issued by the Women's Health Initiative (WHI), that released information informing that use of estrogen for hot flashes and prevention of other chronic conditions had a set of undesirable side effects.

hot flashes disease

A healthy 49 year old woman with no previous poor medical history has been experiencing irregular menstrual periods for 6 months and an increase in hot flashes that interrupt her sleep pattern weekly. She is looking for a treatment method to ease her symptoms.

In considering estrogen, there are a few things she needs to know. She can either wait for symptoms to pass, as 30 - 50% of women experience an improvement in hot flashes after several months or she can take a risk and begin estrogen treatment as some women's hot flashes do not resolve within the estimated 4 -5 year mark. Based on the 2002 research done by WHI this woman may already know the pros and cons that come along with estrogen usage.

Pros: Postmenopausal estrogen may prevent osteoporosis. Randomized controlled trials of estrogen reported an improvement in bone density among estrogen users. A reduction of fractures among estrogen users was displayed in women between 50 - 54 years of age. It should be noted however that use of non-estrogen drugs to treat osteoporosis is suggested over estrogen treatment.

hot flashes sleep problems

Cons: Estrogen use may cause vaginal bleeding, breast tenderness, nausea, headaches, weight change and a variety of other symptoms. It also increases the risk of coronary artery disease and stroke.

She can also consider alternatives to estrogen which include soy and red clover which are known remedies used to treat hot flashes though no substantial evidence can prove their efficacy. Black cohosh, dong quai, evening primrose oil, Chinese herbs and vitamin E are also used to treat hot flashes, but again effectiveness is subjective. Still, out of these alternatives, estrogen seems to be the most successful treatment for hot flashes.

If this woman decides to take estrogen her doctor will probably tell her that there is a range of doses available, subject to modification according to the presence of the problem and progress made. Her doctor should also tell her that after 2 - 3 years, estrogen dosage should decrease and eventually be discontinued.

Hot flashes can be a huge nuisance to women. They can disrupt a woman's daily life and even disturb her sleep. Many women try estrogen therapy in an attempt to ease hot flashes, but this hormone therapy is not without side effects. Estrogen therapy can be dangerous so many women consider more natural alternatives to treat hot flashes. Though they are not as effective as estrogen, they have less side effects. If a woman stills wants to try estrogen therapy for hot flashes despite the risk of side effects, it is imperative that she start on the lowest effective dosage and that she discontinue usage as quickly as possible.

  • Sikon, Andrea and Holly Thacker M.D. "Treatment for Menopausal Hot Flashes". Cleveland Clinic Journal of Medicine. July 2004: 71 (7).
  • "Hot flashes ... in January". Canadian Medical Association Journal. 2004: 170 (1).
  • Miller, Heather and Rose Maria Li, M.D. "Measuring Hot Flashes: Summary of a National Institutes of Health Workshop". Conference report. Mayo Clinic. June 2004: 79.