Hormone therapy still the most effective for menopause symptoms

May 3 2006

A new study has found that estrogen therapy is the best treatment for menopause-related hot flashes.

Non-hormone treatments such as blood pressure medications and antidepressants may offer some relief but hormone replacement therapy remains the best therapy.

The researchers say that like hormone replacement therapy, some non-hormone treatments may also have adverse effects and their use should be limited.

Lead author of the study Dr. Heidi D. Nelson, of Oregon Health & Science University in Portland says women with mild to minimal symptoms, are better off not take anything.

There has been increased interest in non-hormone treatments for menopause symptoms since the Women's Health Initiative study, ground to a halt three years ahead of schedule, in 2002, when researchers found a higher risk of breast cancer, blood clots, stroke and heart attack in women on hormone therapy.

Nelson and her colleagues in their study did a so-called meta-analysis, by pooling and then analyzing the results of 43 clinical trials on non-hormone remedies.

They looked at the effectiveness of each treatment for hot flashes, a common menopausal symptom.

They found that although antidepressants, the blood pressure medicine clonidine (Catapres) and gabapentin (Neurontin), a seizure medication, all reduced to some extent the frequency and severity of hot flashes; red clover isoflavone extracts made little difference and results of the studies on soy isoflavones, another popular remedy, were very mixed.

None of the non-hormone treatments provided complete relief, whereas hormone replacement therapy, significantly reduced the incidents of hot flashes.

Many doctors now suggest that women with symptoms severe enough to disturb their life can take the lowest effective dose of hormone replacement therapy for the shortest period of time possible.

Other experts also say that all non-hormonal treatments have side effects; the antidepressant Paxil can cause headache, insomnia, anxiety and sexual dysfunction.

Women with milder menopausal symptoms, are advised to avoid triggers of hot flashes, such as spicy foods, and to drink cool drinks when a flash occurs.

The findings appear in the May 3 issue of the Journal of the American Medical Association.