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Are alternative treatments for menopausal hot flushes safe?

I am going through the menopause and my main complaint is hot flushes. I have been to my doctor and am waiting for the results of blood tests. Is this the only way the menopause will affect me?

Each woman will have a different experience. Some may only have a few symptoms for a few months or a year, while others may suffer with many symptoms for several years.

The common changes that affect women during the menopause include irregular periods, heavy bleeding, hot flushes, night sweats, vaginal dryness, lack of bladder control, moodiness and poor memory and concentration. Many of these symptoms can also be caused by other diseases, so you need to see your doctor.

My doctor mentioned hormone replacement treatment (HRT). What do you recommend?

Conventional medical treatment for hot flushes due to the menopause includes HRT. This consists of oestrogen alone or a combination of oestrogen and progesterone. HRT can be taken as a tablet or by a patch.

Combined HRT treatment has been shown to increase the risk of a heart attack, a stroke and breast cancer. Oestrogen treatment alone showed increased risk of a stroke, but not a heart attack or breast cancer. The current advice is if HRT is used it should be at the smallest dose for the shortest time possible.

Other non-hormonal drugs that can be used to relieve hot flushes include 'selective serotonin re-uptake inhibitors' (SSRIs) such as Venlafaxine. Megace is a progesterone-based prescription medication, but only for short-term use. Gabapentin and Clonidine are other drugs used for menopausal hot flushes.

Are there alternative therapies that can help? Why are some doctors reluctant to recommend these?

Natural remedies may be effective, but there is a lack of research on the safety and effectiveness of most of them. The alternative treatments that have been studied in well-designed trials include phytoestrogens (iso-flavones), black cohosh and vitamin E.

Iso-flavones are chemical compounds found in soy and other plants such as chickpeas and lentils. They have been shown to help relieve hot flushes in menopausal women, in particular women who have had breast cancer. Black cohosh is a herbal remedy that can be used for up to six months. Vitamin E supplements may help some women with hot flushes, but do not exceed more than 400 IU daily. Tell your doctor if you are using alternative treatments, as they may interfere with prescribed medication.

A recent study showed acupuncture is a safe, effective option with little side-effects for treating hot flushes and night sweats, especially for women being treated with hormone therapy for breast cancer.

You need to make sure that the treatment you choose works and is right for you.