- Question from L: After 5 years on HRT therapy, I was diagnosed with a very small (<3 mm) invasive ductal tumor, which was hormone-receptor-positive. I have had radiation and have been on tamoxifen for 6 months. Any suggestions for the night sweats and hot flashes will greatly be appreciated. I am also curious as to what causes the chills, something I don't remember having when I went through menopause 6 years ago.
- Answers - Debra Barton For moderate to severe hot flashes that interrupt sleep, such as night sweats, one of the best non-hormonal alternatives that we have studied is called Effexor, which is one of the newer antidepressants. We use doses that are lower than what is used for depression. We start with 37.5 mg of extended release Effexor. Women take that for a week. If they are satisfied with their hot flash control, many women stay at that dose. If they aren't satisfied with their hot flash control, we can increase their dose to 75 mg once a day. We have found that reduces hot flashes, including night sweats, by about 60 percent.
- Charles Loprinzi I think that the night sweats are just, in my mind, the nighttime equivalent of hot flashes. With regards to the chills, it is a common complaint that some women call "cold flashes." It's hard to sort everything out, except that it's a temperature-regulatory problem. Sometimes hot, sometimes cold, sometimes sweaty.
- Jennifer Griggs, M.D., M.P.H. There are some lifestyle things that you can try, before going on another medication. Those include exercise (which would have other benefits, of course), reduction in alcohol intake, reducing your caffeine intake, and avoiding spicy foods. At breastcancer.org, you can read a review of Dr. Barton and Dr. Loprinzi's Effexor study in the March Research News.
- Debra Barton Research has shown that before a hot flash, core body temperature rises, so things to keep body temperature down may very well prevent some hot flashes. There is some science behind common sense things we do but don't realize. For instance, drinking cool drinks, wearing cotton layered clothing that breathes, and having some sort of air circulation is very important and may be helpful. The other thing that research has found from lifestyle is that deep breathing can reduce hot flashes by about 40 percent. So deep, slow breaths, practiced twice a day, has been found in controlled studies to be helpful.
- Jennifer Griggs, M.D., M.P.H. It sounds as if you're describing a form of biofeedback or meditation.
- Debra Barton It does get back to the whole idea of stress reduction control.
On Wednesday, March 20, 2002, our Ask-the-Expert Online Conference was called Managing Menopausal Symptoms. Charles Loprinzi, M.D., Debra Barton, Ph.D., and Jennifer Griggs, M.D., M.P.H. answered your questions about hot flashes, vaginal dryness, loss of libido, and other symptoms associated with menopause.
The materials presented in these conferences do not necessarily reflect the views of Breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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