#Hot flashes trial#
#Hot flashes series#

A series of double-blind, placebo-controlled trials suggested that low-dose megestrol acetate is a promising agent for hot flash management in this population. The very limited data available do not indicate an increased risk of breast cancer recurrence with single-agent estrogen use in patients with a history of breast cancer. The risk was not increased with unopposed estrogen therapy. The increased risk was highest for invasive lobular tumors and in women who used hormone replacement therapy for longer periods. The risk of invasive lobular carcinoma was increased 2.7-fold (95% CI, 1.7–4.3), the risk of invasive ductal carcinoma was increased 1.5-fold (95% CI, 1.1–2.0), and the risk of estrogen receptor–positive/progesterone receptor–positive breast cancer was increased 2.0-fold (95% CI, 1.5–2.7). These results are supported by a population-based case-control study suggesting a 1.7-fold increased risk of breast cancer (95% CI, 1.3–2.2) in women using combined hormone replacement therapy. Tumors among women in the hormone replacement therapy group were slightly larger and more advanced than tumors among women in the placebo group, with a substantial and statistically significant rise in the percentage of abnormal mammograms at first annual screening such a rise might hinder breast cancer diagnosis and account for the later stage at diagnosis.

#Hot flashes trial#

In May 2002, the Women’s Health Initiative, a large, randomized, placebo-controlled trial of the risks and benefits of estrogen plus progestin in healthy postmenopausal women, was stopped prematurely at a mean follow-up of 5.2 years (☑.3) because of the detection of a 1.26-fold increased risk of breast cancer (95% confidence interval, 1.00–1.59) in women receiving hormone replacement therapy. Methodologically strong data evaluating the risk of breast cancer associated with hormone replacement therapy in healthy women have been minimal, despite strong basic science considerations suggesting the possibility of such a risk. Physicians and breast cancer survivors often think there is an increased risk of breast cancer recurrence or de novo breast malignancy with hormone replacement therapies and defer hormonal management of postmenopausal symptoms. The proposed mechanism of action of estrogen replacement therapy is that it ameliorates hot flashes by raising the core body temperature sweating threshold however, many women have relative or absolute contraindications to estrogen replacement. When specific information about the care of children is available, it is summarized under its own heading.Įstrogen replacement effectively controls hot flashes associated with biological or treatment-associated postmenopausal states in women. The evidence and application to practice related to children may differ significantly from information related to adults. In this summary, unless otherwise stated, evidence and practice issues as they relate to adults are discussed. Three-quarters of men with locally advanced or metastatic prostate cancer treated with medical or surgical orchiectomy experience hot flashes. There are no comparable data for women with metastatic breast cancer. Vasomotor symptoms resolve spontaneously in most patients in this population, with only 20% of affected women reporting significant hot flashes 4 years after the last menses. Another synonym found in the literature is hot flushes.Īpproximately 20% of women without breast cancer seek medical treatment for postmenopausal symptoms, including symptoms related to vasomotor instability. Hot flashes accompanied by sweating that occur during the sleeping hours are often called night sweats. Physiologically, sweating mediates core body temperature by producing transdermal evaporative heat loss. Sweating can be part of the hot flash complex that characterizes the vasomotor instability of menopause. For most patients with breast cancer or prostate cancer, hot flash intensity is moderate to severe. In premenopausal breast cancer survivors, vasomotor symptoms-including hot flashes and night sweats-have been associated with depression, an effect that may be mediated by sleep disturbance. The severity of hot flashes in patients with breast cancer has been associated with sleep difficulty, higher pain severity, and poor psychological functioning. Hot flashes occur in approximately two-thirds of postmenopausal women with a history of breast cancer and are associated with night sweats in 44% of these women. Treatment options are broad-based and include hormonal agents, nonhormonal pharmacotherapies, and diverse integrative medicine modalities. Hot flashes and night sweats are common in cancer survivors, particularly women, but they can also occur in men.