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Treating hot flashes naturally

Special to The Times

Colleen Dawmen had been plagued for years by severe hot flashes that would wash over her dozens of times a day and awaken her, dripping with sweat, three or four times a night.

“I’d get so overwhelmed by this furnace-like heat that I felt like my head was going to explode,” says the 51-year-old nurse. She didn’t want to take hormones, but black cohosh and progesterone cream had failed to curb her symptoms. “I was at the mercy of these hot flashes,” she says.

For the record:
12:00 AM, Mar. 02, 2005 For The Record
Los Angeles Times Wednesday March 02, 2005 Home Edition Main News Part A Page 2 National Desk 3 inches; 148 words Type of Material: Correction
Hot flash study -- An article in Monday’s Health section about a potential hot flash remedy misstated the number of participants in the two parts of a 100-person study. The article said that, in the first part of the study, 25 participants would be given an amino acid treatment and 25 would be given a placebo, and that in the second part of the study a group of 50 people would be divided into two smaller sections. In fact, both parts of the study will involve the same 100 women, divided into two groups of 50. During the first part of the study, one group of 50 will take the amino acid, while the second group of 50 will take a placebo. During the second part of the study, one of the 50-member groups will take the original amino acid; the second group will take a similar supplement.
For The Record
Los Angeles Times Monday March 07, 2005 Home Edition Health Part F Page 8 Features Desk 3 inches; 148 words Type of Material: Correction
Hot flash study -- An article on a potential hot flash remedy in Monday’s Health section misstated the number of participants in the two parts of a 100-person study. The story said that in the first part of the study, 25 participants would be given an amino acid treatment and 25 would be given a placebo, and that in the second part of the study, a group of 50 people would be divided into two smaller sections. In fact, both parts of the study will involve the same 100 women, divided into two groups of 50. During the first part of the study, one group of 50 will take the amino acid, while the second group of 50 will take a placebo. During the second part of the study, one of the 50-member groups will take the original amino acid; the second group will take a similar supplement.

When she read about a study of an amino acid that might help, she didn’t hesitate to sign up. Within a few weeks, the frequency and severity of her hot flashes had greatly diminished.

“Instead of sweat running down my arms,” says the East Amherst, N.Y., resident, “they were more of just a little blush.”

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Hot flashes may be a popular punch line on late night talk shows, but they’re no joke for millions of menopausal women like Dawmen. Although not dangerous, the unpredictable episodes of flushing that drench women in sweat can be more than an embarrassing nuisance. Hot flashes that occur frequently at night -- causing chronic sleep deprivation, irritability and depression -- can significantly erode quality of life.

Hormone replacement therapy can effectively squelch symptoms in up to 90% of women, but two 2002 studies revealed that the therapy boosted breast cancer risks for some women. Millions of people promptly stopped taking hormones, only to find themselves with no safe and effective therapies to cool their heat surges.

Because hormones worked so well, “there really wasn’t much research done in identifying other hot flash treatments,” says Dr. Janet Pregler, director of the Iris Cantor-UCLA Women’s Health Center in Los Angeles.

The amino acid-based dietary supplement that Dawmen helped test could lead to relief for an estimated 30 million American women who suffer from hot flashes. “Severe hot flashes that continue over a number of years can become a serious condition,” says Dr. Sireesha Y. Reddy, a gynecologist at the University of Rochester Medical Center in New York. “We need safe alternatives, and this is a promising method that could help a lot of women.”

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Doctors aren’t quite sure what causes hot flashes, but they do know that when a woman goes through menopause, her estrogen levels plummet. “The lack of estrogen somehow puts the hypothalamus” -- a tiny gland at the base of the brain that regulates temperature -- “out of kilter,” says Reddy. Estrogen seems to calm the overactive hypothalamus and reduce the number and severity of hot flashes.

The amino acid supplement being tested seems to stimulate the hypothalamus, says Dr. Thomas Guttuso Jr., a neurologist who heads the University of Buffalo research team that is testing the treatment. Amino acids are molecules that combine to make proteins, the building blocks of the body. Many amino acids are acquired through the diet.

Guttuso discovered this amino acid’s potential for taming hot flashes by accident. Seven years ago, he prescribed an amino acid-based drug, the anti-seizure medication gabapentin, to a patient suffering from migraines. “She called a week later to tell me her hot flashes were gone,” he says. “I jumped on it right away because I thought it was fascinating.”

After preliminary research suggested that gabapentin did ease hot flashes, Guttuso organized a larger study involving 59 post-menopausal women who had seven or more hot flashes a day. The 2003 test revealed that taking gabapentin three times a day shrunk the frequency and severity of hot flashes by 54%, compared with a 31% reduction for those on a placebo.

But there was a downside: The drug made some of the women feel dizzy or drowsy, which meant that it couldn’t be used during the day. Because of this limitation, Guttuso sought an alternative. Eventually he uncovered an animal study done by European researchers that indicated a common amino acid found in food acted on the same brain pathways as gabapentin. “That led us to believe that perhaps this amino acid might be effective for treating hot flashes in humans,” he says.

Last year, Guttuso tested the amino acid on 15 post-menopausal women, including Dawmen. Although the amino acid being tested isn’t unusual, Guttuso says, “it’s not commercially available in the form that we’re using, which is highly concentrated and purified.”

Though the final test results won’t be released until later this year, they were encouraging enough to prompt the researchers to launch a larger 12-week study involving 100 women with severe and frequent hot flashes. In the first part of the study, involving 50 of the volunteers, half will get the amino acid treatment in a capsule twice a day, while the remainder will receive a placebo, or dummy pill. In the second part of the trial, involving the other 50 participants, one group will receive the original amino acid, while the other will take a similar-acting amino acid to see which one works best.

To determine the treatment’s effectiveness, participants will keep a daily diary throughout the trial and record the number of hot flashes and their intensity. Results should be available in 2006. “Hopefully, we’ll soon have an all-natural hot flash treatment with virtually no side effects,” says Guttuso. “And because you wouldn’t need a prescription, a lot more women would have access to this potential therapy without having to consult their physicians.”

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Other remedies

Some women take herbal remedies such as soy, red clover extracts and black cohosh that contain estrogen-like chemicals to quell their hot flashes.

However, studies have consistently shown that soy and red clover work no better than placebos. Research results for black cohosh are mixed. Furthermore, researchers don’t know whether these plant-derived estrogens are any safer than conventional hormone replacement therapy, which is composed of animal estrogens.

Some research indicates that popular antidepressants, such as Paxil, Prozac and Effexor, can diminish hot flash symptoms by up to 65%. Although these potent mood-altering drugs can trigger such side effects as a loss of sex drive, weight gain and agitation, “for women who are having severe problems, they might be a reasonable alternative,” says Dr. Janet Pregler, director of the Iris Cantor-UCLA Women’s Health Center in Los Angeles.


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