Hormone Therapy for Hot Flashes

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If hot flashes and night sweats have you fired up about menopause treatment, it might be time to reconsider hormone therapy

The issue of how to deal with menopause has, well, heated up again, and hormone therapy is once again on the rise to ease the discomfort of hot flashes and night sweats

This will undoubtedly surprise those who think the matter was laid to bed eons ago following the Women’s Health Initiative (WHI) study finding that for women taking a combination pill of estrogen and progesterone, the risks (breast cancer, blood clots, heart attacks and strokes) clearly outweighed the benefits (fewer severe menopausal symptoms, less osteoporosis and colon cancer).

Consequently, hormone use for menopause plummeted in Canada over the last decade. But in the last few years, there’s been a concerted effort by some women’s health experts to get hormone therapy reintroduced as a feasible treatment for at least some menopausal women, if not most.

Why? Several reasons, but two stand out.

A Resurgence in Hormone Therapy

First, lots of people argue that the women in the WHI study (average age 67, many of whom already had some heart disease) were not representative of the typical women who seek or need hormone therapy (who are younger, starting menopause, without much heart disease yet). So the WHI study results shouldn’t apply, lots of experts believe, to those women just entering menopause. To that end, recent studies have hinted that such women may actually get some important health benefits from hormone therapy.

Second, hormones remain by far the best therapy for the more severe symptoms of menopause, particularly hot flashes (and new hormone treatments have emerged). So, experts argue, women shouldn’t be nearly as afraid of using them for symptom relief as most women seem to be.

Alternative Treatments for Hot Flashes

“But Art,” some readers may sputter, “aren’t there good alternative treatments for hot flashes, like soy and black cohosh?”

Disappointingly, it doesn’t seem so. Black cohosh has failed to impress in several studies, while a definitive recent study in the journal Menopause found that soy products (tofu, edamame, soy milk, etc.) were of “little use for hot flashes or night sweats.”

But even if hormones may be beneficial for some women, there are still several vital questions to confront, especially:

1. Which hormone formulations are best? No one knows.
2. How long can a woman use hormones before the still-unquestioned long-term risks (breast cancer, especially) begin to outweigh the benefits? No one knows that either.

All in all, I still have reservations about more widespread use of hormones. As a prototypical baby boomer, this is what I’d say to any woman with questions about this issue: The answers, I’m afraid, are still blowin’ in the wind, so, think twice, it’s not always alright. Because if things do go wrong, you may end up as a sad-eyed lady of the lowlands on desolation row by a simple twist of fate.

No wonder our kids hate us, eh?

Dr. Art Hister is a medical writer and health analyst for Global TV.

Originally published in TVW. For daily programming updates and on-screen Entertainment news, subscribe to the free TVW e-newsletters, or purchase a subscription to the weekly magazine.