Treatment options for hot flashes, night sweats

DR. SUSAN REED: Our study was tasked

with doing clinical trials for interventions for menopause.

We were a group of investigators multi-site across the country

from Oakland in California, Indianapolis in the Midwest,

Pennsylvania, Harvard, and Seattle.

We looked most specifically at non-hormonal treatments

because the NIH was looking for alternatives.

Classic symptoms we hear about are the hot flashes

and the night sweats.

I have to say, more commonly today

I see patients that are tolerating those to a degree.

What women are more worried about

is their ability to sleep and therefore

function in their home and their workplace.

So I think the good thing that came from our study

is that there are options for women that--

for women that are unable to take hormones.

We looked specifically at selective serotonin reuptake

inhibitors, or SSRIs.

These are medications most commonly used

for mood or depression.

When used at lower doses, prior work

had suggested that these were relatively effective

for hot flashes and menopausal symptoms.

And what we found was that neither the exercise

or the yoga improved the frequency or the severity

of hot flashes over regular exercise or routine activity.

And the omega-3 fatty acid versus an omega-3 placebo

was not effective.

What we did see-- and we've already known

this-- is that both exercise and yoga

are very good for everyone's health and very

important for quality of life and, particularly for exercise,

physical health.

Yoga, we saw improvement in overall sense of well-being

or quality of life.

Our last trial looked at sleep.

And this was an intervention where

we did a telephone-based cognitive behavioral therapy

for sleep in women with menopausal symptoms

and specifically sleep symptoms related to menopause.

This had not been studied before,

and the party line had been, again, that estrogen was

effective for sleep at midlife.

And a telephone-based intervention

was as good if not better than the estrogen.

This kind of intervention, it would

be exciting to see health care organizations looking

at rolling out.

This is a simple telephone-based therapy

that would be cost effective and not have to involve medication

for women.

It's really critical to have women prioritize what's

bothering them the most.

I ask them to literally list in order the things

that they want to improve upon.

And then we choose selective therapies

for those rather than a broader medication

to really target the areas that they're

most interested in improving.

The other thing I say to all my patients

is we can feel fairly confident that almost all women we

have something that we can do to help them with.

Even if they've got wicked hot flashes from a breast cancer,

there are some tools that we have

that are really going to help each individual woman.