Hot flashes, cold facts

WOMEN seeking treatment for hot flashes have few options besides hormone therapy, and more research is needed to understand what really helps, according to a new study.

Published last week in the Journal of the American Medical Assn., it found that antidepressants such as fluoxetine (Prozac) and paroxetine (Paxil) appear to curb frequency and severity of hot flashes, and that gabapentin (Neurontin), an antiseizure drug, and clonidine, a drug for high blood pressure, can help too. None is as effective as estrogen.

“It’s a short list,” says Dr. Heidi D. Nelson, the study’s lead author and a professor at Oregon Health & Science University. The best option, she says, “may turn out to be what an individual woman tolerates best.”

Nelson’s analysis reviewed 43 of the higher-quality studies on nonhormonal therapies. But even many of these studies were less than ideal. The analysis also showed that the herb red clover appears to be of little value and that the benefits of soy are uncertain. Hormone therapy may still be the best choice for some women, Nelson says, but it too has side effects, and experts recommend using the lowest dose for the shortest amount of time.

Nelson says researchers need to better understand the cause of hot flashes to create better therapies.