Vasomotor Symptoms (Hot Flashes & Night Sweats)

What Are They?

Hot flashes are described as episodic sensations of heat, intense sweating, and flushing affecting the face and chest, which are often accompanied by heart palpitations and anxiety. Each particular episode lasts 3-10 minutes and episodes can recur with varying frequency.

How Common Are They?

Hot flashes are common with breast cancer therapy. The average incidence of hot flashes in women taking Tamoxifen is 60-70%. Studies comparing Tamoxifen to Aromatase Inhibitors (Arimidex, Femara, Aromasin) have shown that the incidence of hot flashes is slightly lower with aromatase inhibitors.

What Causes Them?

Multiple breast cancer treatments result in a low estrogen state, including hormone-blocking medications, such as Tamoxifen, Arimidex, Femara, Aromasin, and Lupron. Chemotherapy may cause a temporary reduction in estrogen or possibly induce premature menopause. Decreased estrogen levels to the brain confuse the body’s thermostat. Chemical messengers are sent throughout the body, which result in an increased heart rate, dilated blood vessels, and sweating.

What Can Be Done for Them?

The intensity and severity of hot flashes often decreases after several months. In the meantime, you can consider:

  • Lifestyle modification
  • Several non-hormonal prescription medications have been/a shown to decrease hot flashes moderately, including:
    • Venlafaxine (Effexor)
    • Paroxetine (Paxil) – this should not be used with Tamoxifen
    • Gabapentin Neurontin)
    • Citalopram (Celexa)
    • Clonidine (Catapres)
  • Ask your doctor if a prescription medication may be right for you.
  • Complementary therapies, such as acupuncture, meditation, massage therapy, and yoga, can also help reduce vasomotor symptoms:
    • A randomized controlled trial published in the Journal of Clinical Oncology 2009compared 12 weeks of Effexor to 12 weeks of acupuncture. Both reduced hot flashes by 50%. The beneficial effects of acupuncture lasted up to 3 months. In addition, acupuncture patients reported an increase in sex drive, improvement in energy, clarity of thought, and sense of well-being.
    • Ask your doctor if you might benefit from complementary therapies and for a referral to an integrative oncology specialist.

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