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Query: UMLS:C0600142 (hot flushes)
 1,242 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To avoid the risks of oestrogen therapy in post-menopausal women, we have examined the effects of a progestin, megestrol acetate (MA), on hot flushes and bone metabolism. Ten normal post-menopausal women were studied before and after the oral administration of 20, 40 and 80 mg of MA daily for 4 wk at each dose level. Finger temperature and skin resistance were recorded for 8 h as objective indices of flushing and perspiration, respectively. The fasting ratios of urinary calcium: creatinine (Ca/Cr) and hydroxyproline: creatinine (OHPr/Cr) were used as indices of bone resorption. A reduction (P less than 0.01) of flushing episodes was noted on all dose levels of MA, with 56, 11, 6 and 1 flushes occurring on 0, 20, 40 and 80 mg of medication. A decrease (P less than 0.05) of Ca/Cr was noted only with 80 mg of MA, whereas OHPr/Cr remained unchanged. We conclude that progestin therapy may provide an alternative mode of treatment for post-menopausal hot flushes. Definitive demonstration of an effect on post-menopausal bone resorption will require a long-term study of bone density.
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PMID:Effect of megestrol acetate on flushing and bone metabolism in post-menopausal women. 728 87

The present study was undertaken to evaluate objective methods of monitoring postmenopausal hot flashes. Continuous recordings of finger and core temperature and sternal skin conductance were carried out in 8 postmenopausal and 4 premenopausal women. Four postmenopausal patients were studied a second time following 30 days of daily oral administration of ethinyl estradiol 0.05 mg. One hundred twenty flashes were subjectively noted and recorded during 104 hours of study in the postmenopausal women. Eighty-two, 98, and 81% of subjective flashes were associated with changes in finger temperature, skin conductance, and core temperature, respectively. The rate of occurrence and magnitude of changes of physiologic markers were significantly greater (P less than .01) in postmenopausal than premenopausal women. Estrogen replacement therapy not only eliminated the subjective sensations but also significantly reduced (P less than .02) the frequency and magnitude of the changes in physiologic function measured by finger temperature. Measurement of skin conductance changes was the single most sensitive and specific indicator of hot flashes. The simultaneous change of both skin conductance and finger temperature, although less sensitive, was a very specific indicator of a hot flash. These results support the concept that the measurement of physiologic changes can be used to assess objectively the occurrence of this symptom complex.
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PMID:Objective techniques for the assessment of postmenopausal hot flashes. 746 49

Six patients with symptomatic leiomyomata uteri and in whom surgical treatment was indicated received, during 3 months, intramuscular leuprolide acetate, 3,75 mg monthly, in order to 1) achieve a reduction of myomata size and 2) recover an anemic patient before surgery. In every patient, amenorrhea was induced since the second month of treatment. A significant decrease of myomas sizes was achieved. The reduction of the volume of the largest myoma in each case, varied between 51% and 77% (x = 60% +/- ES 4,3) LH and estradiol plasma levels diminished significantly and FSH did not changed in response to treatment. Side effects were well tolerated. Hot flashes were present in all patients, headaches in 2 and loss of strength in 2. Surgery was accomplished after 3 months of treatment. Myomectomy was performed in 5 cases and total hysterectomy in 1. Uterine shrinkage and the period of amenorrhea induced by Lupron-depot facilitated hysterectomy and myomectomy techniques and the recovery of one patient with a severe anemia.
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PMID:[Size reduction of uterine myomas with monthly administered leuprolide acetate]. 756 60

To evaluate the efficacy and safety of nafarelin before hysterectomy in a prospective placebo-controlled trial, we randomized 188 pre-menopausal women with uterine fibroids (n = 111), menometrorrhagia (n = 58) or pelvic pain (n = 19) to receive either nafarelin (200 micrograms twice daily as a nasal spray) or a placebo for 3 months before abdominal hysterectomy. The data analysis could be performed in 166 women, of whom 107 received nafarelin and 59 a placebo. Nafarelin led to a rise in blood haemoglobin (5.5 g/l) and to a decrease in uterine volume (23.7%). This, however, gave no objective benefit during surgery (similar operative durations and blood losses). The uteri from patients treated with nafarelin (255.5 +/- 12.6 g, mean +/- SD) were significantly lighter (P = 0.029) than those from patients treated with a placebo (346.2 +/- 35.7 g). Histological examination of the fibroids or uteri revealed changes typical for hypo-oestrogenism, but no specific histological pattern could be established. The endometrium was proliferative in 56% and showed mild hyperplastic features in 10% of patients given nafarelin, whereas the respective figures for the placebo group were 41 and 0%. Hot flushes were the most common side-effects, being reported by 61% in the nafarelin group and 35% in the placebo group. Nafarelin can be useful as a pre-surgical adjunct in a patient scheduled for abdominal hysterectomy if there is a need to raise the haemoglobin concentration or to reduce the size of the uterus.
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PMID:Decrease in symptoms, blood loss and uterine size with nafarelin acetate before abdominal hysterectomy: a placebo-controlled, double-blind study. 759 17

Hot flashes are the most frequent somatic complaint of women going through the menopause. Although the exact pathophysiology of the hot flash remains unknown, it appears to be related to an alteration in the set point of the hypothalamic thermoregulatory center. With the withdrawal of estrogen, some event parallel to the release of GnRH (and subsequent release of LH) causes a decrease in the set point of the thermoregulatory center. The hot flash, with its characteristic sweating and vasodilation, represents the attempt to decrease the body core temperature and restore equilibrium. Estrogen therapy reliably treats hot flashes in the majority of women in addition to its proven beneficial effect on heart disease and osteoporosis. It is rare that health care providers can so reliably and safely positively impact on a patient's symptoms and overall health.
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PMID:The hot flash: pathophysiology and treatment. 760 59

Plants contain compounds with oestrogen-like action called phytoestrogens. Soy contains daidzin, a potent phytoestrogen, and wheat flour contains less potent enterolactones. We aimed to show in 58 postmenopausal women (age 54, range 30-70 years) with at least 14 hot flushes per week, that their daily diet supplemented with soy flour (n = 28) could reduce flushes compared with wheat flour (n = 30) over 12 weeks when randomised and double blind. Hot flushes significantly decreased in the soy and wheat flour groups (40% and 25% reduction, respectively < 0.001 for both) with a significant rapid response in the soy flour group in 6 weeks (P < 0.001) that continued. Menopausal symptom score decreased significantly in both groups (P < 0.05). Urinary daidzein excretion confirmed compliance. Vaginal cell maturation, plasma lipids and urinary calcium remained unchanged. Serum FSH decreased and urinary hydroxyproline increased in the wheat flour group.
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PMID:Dietary flour supplementation decreases post-menopausal hot flushes: effect of soy and wheat. 1943 77

Sixty-one women, reporting hot flushes once a week or more frequently, completed questionnaires eliciting information about demographic details, health, mood and health beliefs. They were interviewed and asked to choose between no treatment, hormone treatment (HRT), psychological treatment (cognitive-relaxation therapy (CRT) and no preference for either CRT or HRT. Seventy-five per cent wanted treatment, with approximately 40% of these women preferring HRT and 60% CRT. Women who wanted treatment for hot flushes were significantly more anxious, coped less well with stress, had lower internal locus of control scores and lower self-esteem, compared with those not seeking treatment. Hot flush frequency was the same for both groups, but those wanting treatment viewed flushes as being more problematic. Few differences emerged between those preferring hormonal or psychological treatment. However, particular reasons were given based upon past experience, views about medication and practical considerations. This study highlights the need for the development of alternative treatment regimens for women seeking help for menopausal problems.
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PMID:Determinants of treatment choice for menopausal hot flushes: hormonal versus psychological versus no treatment. 764 Jul 22

Menopausal hot flashes are thought to be a disorder of thermoregulation initiated centrally within the medial preoptic area of the hypothalamus. These heat-loss mechanisms appear to be activated in the presence of normal core body temperature. Previous studies have demonstrated that thermal stimuli have the potential to alter sleep stages. We performed 24-hour ambulatory recordings of hot flashes and all-night sleep parameters on 12 postmenopausal women with hot flashes and seven postmenopausal women without flashes to determine whether the presence of hot flashes prior to sleep or during sleep itself would result in alterations in sleep pattern. The results show that hot flashes are associated with increased Stage 4 sleep and a shortened first rapid eye movement period. Hot flashes occurring in the 2 hours prior to sleep onset were positively correlated with the amount of slow-wave sleep. The central thermoregulatory mechanism underlying hot flashes may affect hypnogenic pathways inducing sleep and heat loss in the absence of a thermal load.
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PMID:The thermoregulatory effects of menopausal hot flashes on sleep. 780 62

The incidence of climacteric symptoms was determined in 247 healthy premenopausal women in a community setting. These volunteers had been recruited to a longitudinal study of bone density. Of these subjects, 46 ceased to menstruate during the study, and in this subgroup symptoms were compared before and after cessation of menstruation. Only hot flushes increased after cessation of menstruation in the longitudinal study and showed age correlation in the cross-sectional study. Hot flushes thus emerged as a true menopausal symptom. Although evidence for this is weaker, cold sweats and suffocation seem likely to be genuinely menopausal. Breast discomfort and the four mood symptoms of irritability, excitability, depression and poor concentration improved after cessation of menstruation, and this study gives no support for their being part of the menopausal syndrome; it suggests that these symptoms are more likely to be related to menstruation than to the menopause.
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PMID:Climacteric symptoms in healthy middle-aged women. 791 16

Menopausal hot flashes are a significant problem for women. Hot flashes can impact on daily functioning, particularly when they disrupt sleep, leading to fatigue and irritability during the day. However, our knowledge about this primary complaint of menopausal women is far from complete. It is known that a hot flash is associated with thermoregulatory, cardiovascular, and endocrine changes. However, much is unknown about the phenomenology of hot flashes, such as the range of variability in the pattern and longitudinal course of hot flashes. Although estrogen plays a role in the etiology of hot flashes, the mechanism by which its withdrawal precipitates hot flashes and its replacement relieves them is not understood. Nor do we know what it is that triggers individual hot flash episodes. We are beginning to learn about factors, such as ambient temperature, that modulate the frequency of severity of hot flashes. And very new data suggest that the ingestion of certain foods may influence hot flashes via estrogenic substances present in the food plants. Although there is much anecdotal information about herbs and other nonconventional remedies, little or no research had been done to assess the efficacy or safety of these methods for the treatment of hot flashes. An immediate focus on some of the most promising of these therapies could broaden the available treatment options and should provide new insights into the mechanism underlying hot flashes.
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PMID:Hot flashes: phenomenology, quality of life, and search for treatment options. 792 52


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