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Hormone Therapy and Hot Flashes: Making Decisions in the Face of Uncertainty

Review on January 19, 2010

hot flashes HRT

Hot flashes are an uncomfortable symptom of menopause affecting a large number of menopausal women. Hot flashes impact on the daily lives of women and can interfere with sleeping patterns too. Various studies detailed below have studied the relationship between Hormone Replacement Therapy (HRT) and hot flashes, and aim to determine whether or not HRT can improve the quality of life of menopausal women by alleviating menopausal symptoms such as hot flashes.

HRT comes in many numerous forms, including estrogen plus progestin, and estrogen alone. Because further scientific research is needed, it is not advisable for postmenopausal women to regularly use estrogen plus progestin to prevent chronic conditions such as heart disease. Also, insufficient evidence means that it is not feasible to recommend postmenopausal women who have had a hysterectomy to use estrogen alone therapy or not, in order to prevent lasting conditions.

Whether or not women choose HRT, making lifestyle changes to help reduce the risk of chronic diseases is important. Evidence from the Women's Health Initiative trial demonstrates that women who choose to use HRT can lower their risk of breast cancer by engaging in more exercise.

Menopausal symptoms such as hot flashes are less of a worry than more serious conditions but can still greatly affect a woman's quality of life. HRT is renowned for its ability to alleviate menopausal symptoms and is particularly successful in easing hot flashes and night sweats.

Although researchers from the Women's Health Initiative trial claim that estrogen plus progestin therapy did not impact on health-related quality of life, it was clear that women who received HRT were more likely than others to experience less severe hot flashes and night sweats.

hot flashes symptoms

Data from this trial and other similar studies showed a reduction in hot flashes among older women (in their early 60s) using HRT. The Heart and Estrogen/progestin Replacement Study found that HRT in older women had differing effects on their quality of life; women who were relieved of hot flashes saw a decline in physical energy while those suffering from hot flashes saw an improvement in emotional actions.

Even though HRT can produce side effects such as vaginal discharge, uterine bleeding, and breast tenderness, it does alleviate some menopausal symptoms, such as hot flashes and is still regarded as an efficient treatment.

Women who suffer unbearable menopausal symptoms such as severe hot flashes, and who turn to HRT as the most appropriate therapy should continue to do so, despite questions about its safety. Instead, these women should be informed about the common and potential health risks and benefits, so they can make an educated decision regarding its use.

Regarding the side effects of HRT, using data from the Women's Health Initiative trial, Grady estimates that around one major adverse event will occur in every one thousand 50-year-old women using HRT for a twelve month period.

Data from the Women's Health Initiative trial has impacted greatly on the medical world and its findings have reinforced the idea that HRT generally carries risks greater than its benefits. However, although HRT can produce side effects it does relieve the menopausal symptom of hot flashes. Despite data showing that estrogen plus progestin therapy did not impact on health-related quality of life, it's evident that women opting for HRT will experience less severe hot flashes and night sweats. The many uncertainties surrounding the role of HRT mean that more research is needed, especially with regard to its impact on quality of life.

  • Arch Intern Med. 2004;164:2308-2312.