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

Estrogen therapy is extremely effective in relieving menopausal symptoms such as hot flushes, night sweats, urogenital atrophy and certain psychological symptoms. The short term side effects from this therapy are usually mild and self-limiting. They are more common in women who commence hormone replacement therapy some years after the menopause than in those who start treatment at about the time of the ovarian failure. Pre-existing gynaecological conditions such as fibroids and endometriosis can be worsened by estrogen therapy. The majority of published studies suggest a beneficial effect of postmenopausal estrogen therapy on cardiovascular and cerebrovascular disease. These effects may be mediated by favourable changes in lipids, but other mechanisms may also be involved. It is uncertain whether the adverse changes in lipids caused by progestogen therapy will reduce any of the benefits of estrogen therapy on the cardiovascular system. Osteoporosis is the major bone disease of the Western world; long term estrogen therapy will prevent its development in most postmenopausal women. The risk of endometrial carcinoma is increased with unopposed estrogen therapy; this increased risk appears to be abolished if a progestogen is added at an adequate dose and duration for each cycle. The risk of ovarian or cervical cancer is not increased with estrogen therapy. There may be an increased risk of breast carcinoma with long term postmenopausal estrogen use, but the studies show inconsistent results.
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PMID:A risk-benefit assessment of estrogen therapy in postmenopausal women. 222 68

Symptoms due to estrogen deficiency begin in the perimenopausal years and progress as serum levels of this hormone decrease Vasomotor instability, manifested by hot flushes or night sweats, may persist for several months to a few years. Psychologic symptoms include anxiety, tension, depression, insomnia, palpitations, and headaches. Atrophy of the genital epithelium may result in senile vaginitis with symptoms of irritation, burning, pruritus, dyspareunia, and even vaginal bleeding. Even the lower urinary tract mucosa is dependent upon estrogen. Postmenopausal osteoporosis affects 25 to 50% of older women and increases the risk for vertebral, hip, and other fractures. Estrogen therapy for menopausal complaints has received adverse publicity because several reports have indicated that unopposed estrogens increase the risk of endometrial cancer. Added progestogen not only negates this risk but reduces the incidence of endometrial adenocarcinoma in estrogen-progestogen users to less than that observed in untreated women. Estrogen replacement therapy does not increase the risk of breast cancer; the incidence of this malignancy, however, was also less in the estrogen-progestogen users when compared with either the untreated women or from that expected from the national cancer surveys. In evaluating postmenopausal women for hormone replacement, the benefits of estrogen-progestogen therapy must be weighed against possible risks.
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PMID:The menopause. 351 23

In a prospective, double-blind, randomized, cross-over trial, the effects of oral oestradiol, 2 mg daily, on the endometrial histology, frequency and severity of vaginal bleeding, and the symptomatic and psychological status of postmenopausal women were compared with those of oral oestradiol, 2 mg daily, plus oestriol, 1 mg daily. Both therapies were prescribed for 3 months on a cyclical basis. The addition of oestriol to oestradiol did not modify the endometrial response. The prevalence of proliferative/hyperplastic endometrium (64%: 9 of 14 biopsies) was similar after both treatments and there were no significant differences in either the frequency or heaviness of vaginal bleeding. Both therapies significantly reduced hot flushes, night sweats and vaginal dryness: no significant differences in effect on the symptomatic and psychological status were recorded. The addition of 1 mg of oestriol to 2 mg of oestradiol did not confer any benefit and the value of such an addition is challenged.
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PMID:Oestriol with oestradiol verses oestradiol alone: a comparison of endometrial, symptomatic and psychological effects. 352 65

A randomised, double-blind, cross-over study into the effect of graded sequential mestranol and norethisterone on climacteric symptoms was performed. The study group consisted of 23 post-menopausal women who had previously undergone hysterectomy. Active therapy resulted in a significant reduction in hot flushes and night sweats. There was a slight improvement in insomnia, lack of energy and confidence but the other symptoms were not significantly altered. A small placebo effect was noted but this was only significant 1 mth after active treatment had been discontinued in the group of women receiving placebo second. Active treatment also resulted in a significant reduction in serum sodium, calcium, albumin, alkaline phosphatase and cholesterol, and increase in serum triglycerides, but no alteration in the other biochemical parameters, weight or blood pressure.
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PMID:A randomised, double-blind, cross-over study into the effect of sequential mestranol and norethisterone on climacteric symptoms and biochemical parameters. 675 Mar 25

A randomized double-blind cross-over study into the effect of northisterone on climacteric symptoms was performed on 23 postmenopausal women. Active therapy resulted in a significant reduction in the number and severity of hot flushes and night sweats. There was also a slight improvement in memory, insomnia and lack of energy but the other climacteric symptoms were not consistently altered. Side effects were minimal. There was a significant reduction in serum calcium, alkaline phosphatase, cholesterol, triglycerides, follicle-stimulating hormone and luteinizing hormone levels. There was a variable effect on serum creatinine and urea but there was no significant alteration in the other biochemical profiles, liver-function tests, weight or blood pressure.
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PMID:A randomized double-blind cross-over trial into the effect of norethisterone on climacteric symptoms and biochemical profiles. 680 99

The climacteric is a universal phenomenon which has received relatively little attention from psychiatrists, psychologists, sociologists, anthropologists and social workers all over the world, but almost no research on this subject has been carried out in the Third-World countries. This study, carried out in India, has been conducted for the purpose of unravelling the difficulties that Indian women have to face during the climacteric. 405 married women between 40 and 55 yr of age from the general population were contacted and interviewed. The results, obtained with the menopausal symptom checklist prepared by the authors, indicate (as do other recent surveys) that hot flushes, night sweats and insomnia seem to be clearly associated with the menopause. Also the incidence of other symptoms is described. Despite embarrassment or discomfort experienced from these symptoms by a majority of women, only 10% had apparently sought medical treatment. This study underlines the necessity of a multidisciplinary approach to the problems of menopause and ageing.
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PMID:Climacteric symptoms: a study in the Indian context. 725 31

The possible role of of the marked changes in the regulation of female sex hormones has been implicated in the higher prevalence rate of anxiety and affective disorders in women. There is no evidence, however, for a direct relationship between specific hormone alterations and psychiatric, nosologic entities in the critical periods (premenstrual, postpartum, menopausal). The menopausal psychosyndrome can develop as a result of a chain reaction triggered by the fairly universal and specific vasomotor symptoms: hot flushes and night sweats. The hormone substitution therapy of menopause may have a prompt effect both on the somatic and psychic symptoms, by suspending the domino effect. In addition to that oestrogen has some activating and mood elevating effect, while progesteron can reduce anxiety and related symptoms.
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PMID:[Psychoendocrinology of menopause]. 787 20

Estrogen replacement therapy (ERT) is very effective in relieving many menopausal symptoms such as hot flushes, night sweats, urogenital atrophy and psychological disturbances. Moreover, it is effective in the prevention of postmenopausal osteoporosis and has a favourable effect on some risk factors for cardiovascular disease in the long term, via several mechanisms including mediating effects on the lipid profile. Most of these beneficial effects are maintained with transdermal estradiol therapy, involving the use of a cutaneous delivery system attached to the skin which delivers a controlled rate of estradiol over a period of up to 4 days. However, the clear demonstration of a favourable effect on some risk factors for cardiovascular disease remains to be established. Transdermal administration of estradiol appears to be at least as effective as oral conjugated estrogen therapy on most of the end-points which have been evaluated, but allows a lower dose to be used, avoiding some of the metabolic adverse effects experienced with oral treatment. Endocrinological adverse effects, such as breast tenderness, breakthrough bleeding and fluid retention, are similar in both treatments, and can be minimised by dose adjustments in most cases. The most common adverse effects related to transdermal therapy are local skin reactions at the site of application. These are usually mild and transient in nature, and can be overcome by changing the site of application. Serious risks of transdermal therapy appear to be the same as those for other forms of ERT, namely an increased risk of endometrial hyperplasia and cancer with estrogen therapy alone. However, combination therapy involving the sequential administration of a progestogen has been shown to substantially reduce the risk of endometrial proliferation. The potential increased risk of breast cancer has been controversial and appears to be minimal with ERT. The role of progestogens on breast cancer risk remains controversial, but the data to date do not indicate any significant change in risk when progestogens are added to ERT.
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PMID:A risk-benefit appraisal of transdermal estradiol therapy. 828 Apr 4

This study examines the symptoms after a natural menopause recalled by women aged 50-89 years. We determined the frequency and clustering of symptoms, the effect of age on symptoms, and the relation of symptoms to the use of estrogen therapy in a cross-sectional, community-based study of 589 Caucasian, middle- to upper-middle-class women from Rancho Bernardo, California. At the time of menopause, 55% of the women reported that they felt life was getting better and 57% were more cheerful. The most frequently recalled symptoms were hot flushes (74%), propensity to weight gain (45%), night sweats (35%), tiredness (32%), and insomnia (28%). Irritability was reported by one-fourth, depression by one-fifth. Nearly 11% reported anxiety about looking older. The recalled prevalence of hot flushes, irritability, weepiness and tiredness did not vary by current age, but younger women were significantly more likely than older women to have experienced night sweats, visible flushes, depression, anxiety about looking older and insomnia. Principal components factor analysis yielded four main independent factors: psychological symptoms (21% of the variance), vasomotor symptoms (14%), positive feelings (11%), and negative self-image (8%). The four symptom groupings suggest different causal mechanisms. Forty-two percent reported past, and 27% reported current use of estrogen therapy. Both past and current hormone users were significantly more likely to report menopause symptoms than non-users. Estrogen use was not associated with positive feelings or self-image at the time of menopause. Although three-quarters experienced symptoms, the majority of women reported positive feelings about menopause.
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PMID:A community-based study of menopause symptoms and estrogen replacement in older women. 853 87

Hot flushes and night sweats are one of the main symptoms accompanying the menopause, and are a main reason for seeking medical help at this time. This study of 61 women (reporting hot flushes once a week or more) investigates dimensions of subjective reporting using open questions and rating scales. Two separate factors were delineated using a principal component factor analysis - frequency (of hot flushes and night sweats) and problem ratings (of distress, interference and perception of flushes as problematic) - which had high test-retest reliability. The frequency ratings correlated highly with prospective daily monitoring. Depressed mood, anxiety and low self-esteem, but not frequency, discriminated between those who regarded flushes as problematic and those who did not. It is suggested that these two subjective measures should be used in assessment and in evaluation of hormonal and psychological interventions.
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PMID:A psychological analysis of menopausal hot flushes. 856 66


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