The US Food and Drug Administration (FDA) has approved a novel estrogen-based drug for women for the treatment of moderate-to-severe vasomotor symptoms and osteoporosis associated with menopause. Duavee (Wyeth Pharmaceuticals) is a once-a-day tablet containing a combination of conjugated estrogens and bazedoxifene, an estrogen agonist/antagonist.
Several recent studies have examined the impact of various types of physical activity on menopausal symptoms, including hot flashes, night sweats, and sleep disturbance.
Approximately seventy percent of all women experience hot flashes and/or night sweats during the menopause transition (Stearns et al, 2002). Until recently, estrogen therapy was the treatment of choice for most women who sought treatment for hot flashes, but today many women are pursuing non-hormonal treatments, including over-the-counter complementary and alternative medicines (CAMs) for the treatment of these symptoms.Â
In a recent study comparing hot flashes in 934 cancer survivors (90% of whom had breast cancer) and 155 age-matched control subjects who never had cancer, researches observed that cancer survivors reported more frequent, severe, and troubling hot flashes.
In a recent randomized, single-blind, controlled, clinical trial, 187 postmenopausal women reporting at least 7 hot flashes per day received five weekly sessions of either clinical hypnosis or structured-attention control. Hot flash score were assessed by daily diaries on weeks 2 to 6 and at week 12.
The FDA recently approved a 7.5-mg formulation of the selective serotonin reuptake inhibitor (SSRI) paroxetine mesylate for the treatment of hot flashes.  It will be marketed under the name of Brisdelle.
Studies assessing the effectiveness of complementary and alternative medicines (CAM) for the treatment of menopause-related hot flashes have yielded conflicting results. Most studies have demonstrated that treatments such as soy and black cohosh are not likely to be effective in most women; however, a new study suggests that women who take higher doses (100 to 200 mg)of isoflavones and more frequent dosing (2-3 times per day) may experience a greater reduction in the frequency of hot flashes.
For the treatment of menopausal vasomotor symptoms (VMS), such as hot flashes and night sweats, selective serotonin reuptake inhibitors (SSRIs) are effective and well-tolerated. Positive effects are observed within 4 weeks of the initiation of treatment. However, we do not know how long treatment with an SSRI must be continued in order to maintain control of VMS. Nor do we know if VMS will recur after discontinuation of SSRI or if recurrent VMS may be less frequent or less bothersome after receiving SSRI treatment. A recent report from Dr. Hadine Joffe and colleagues at the Center for Women’s Mental Health assessed the recurrence of vasomotor symptoms in women treated with SSRIs.
In a large study from Australia, researchers found that menopausal women who ate diets high in fruit, certain vegetables, pasta and red wine were 20% less likely to have hot flashes and night sweats.
A substantial proportion of women transitioning into menopause experience a new onset or recurrence of depressive symptoms.  A new study from the Center for Women’s Mental Health indicates that duloxetine (Cymbalta) is effective for the treatment of depression and may also have a beneficial effect on vasomotor symptoms (hot flashes and night sweats).
