Hot Flahes
Hot flashes are a common side effect in women who received hormonal therapy (endocrine therapy) for breast cancer and men who received androgen deprivation therapy for prostate cancer
- Patients typically experience a feeling of intense heat with sweating and elevated heart rate and usually lasts a few minutes. This can occur several times a day depending on the individual.
Hot flashes occur because:
- Capillaries of our body’s circulating system dilate and constrict quickly without the usual hormones to support this, and when the rapid dilation of the capillaries comes, body sweats with flushing especially on our face.
- The capillaries can then constrict (close) quickly which results in a cold and chill sensation.
- This sudden and rapid change of our body’s circulating dynamics creates an uncomfortable sudden surge of heat and sweating.
Patients have reported trying a number of different ways to cope with hot flashes with various results. Some try herbs or meditations while other try medications. Many patients have tried an over-the-counter herb supplement called black cohosh (Cimicifuga racemosa [L.] Nutt.) with varying results. Black cohosh has been shown to be safe if used for six months. Safety beyond six months is not clear. How it affects the estrogen and estrogen receptors is also not clear. Caution is advised until we have better quality and safety data available. Do not confuse black cohosh with blue cohosh which contains chemicals that can damage the heart and raises blood pressure.
Several anti-depressants have been moderately successful in reducing hot flashes.
- These medications include Effexor (venlafaxine), Prozac, Paxil, Zoloft, and Garbapentin.
- However, in women who take Tamoxifen, Prozac, Paxil and Zoloft can reduce the active metabolite of Tamoxifen and can potentially reduce the drug’s efficacy.
- It is generally advised that a different anti-depressant be prescribed when possible.
- Effexor is a common drug prescribed for hot flashes and is effective in reducing the symptom in 60% of patients.
Some side effects (such as nausea or others) may occur with Effexor. Report these side effects to your doctor early if you experience them.
- Anxiety
- Depression
- Dry mouth
- Fatigue
- Hot flashes
- Insomnia
- Joint pain
- Lymphedema
- Memory loss
- Numbness and tingling
- Pain
- Sexual changes
- Weight gain
