ASRM: Etiology, Treatment of Hot Flushes Reviewed

Hot flushes likely related to changes in CNS neurotransmitters tied to estrogen withdrawal

WEDNESDAY, Oct. 19 (HealthDay News) -- Vasomotor symptoms (VMS) are common among women entering and completing the menopause transition, are mediated by central nervous system (CNS) neurotransmitters, and respond to estrogen replacement therapy, according to a report published in the October issue of Climacteric to coincide with its presentation at the annual meeting of the American Society for Reproductive Medicine held from Oct. 15 to 19 in Orlando, Fla.

David F. Archer, M.D., from the Eastern Virginia Medical School in Norfolk, and colleagues presented an overview of the acknowledged experts' current knowledge on the etiology and treatment of VMS in postmenopausal women.

The authors found that women of all cultural and ethnic backgrounds suffer from VMS as they enter and complete the menopause transition. Narrowing of the thermoneutral zone in the brain causes VMS, specifically hot flushes. These are likely to be related to changes in CNS neurotransmitters associated with estrogen withdrawal. Symptomatic women also show altered peripheral vascular reactivity. The most effective treatment for hot flushes is estrogen replacement therapy, with robust improvement in symptoms during objective monitoring. Among other treatment options, selective serotonin or norepinephrine reuptake inhibitors, and gabapentin show higher efficacy than placebo, but data from subjective assessment of responses to therapy are inaccurate. Recent data indicating an association of hot flushes with increased cardiovascular risks and lower breast cancer incidence need to be confirmed.

"A woman going through a difficult menopause should make sure that she talks this over with her doctor to find the best solution for her," Tobie J. de Viliers, M.D., president of the International Menopause Society said in a statement.

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