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At age 45, I'm beginning to "go through the change" and am having to deal with all the typical symptoms, including hot flashes and night sweats. But because breast cancer runs in my family, I'm a little scared of hormone replacement therapy, having read that there is probably some connection between using these hormones and developing breast cancer. Do I have other options? Are there other ways to alleviate these terrible symptoms without increasing my cancer risk even more than it already is?
Answer:
There are many steps you can take to reduce the symptoms of menopause or perimenopause that don't involve hormone use. For someone in your situation, I'd say:
Get Practical!
lower the thermostat
wear layered cotton clothing,
limit or avoid caffeine, chocolate, and alcohol,
eliminate hot showers, baths, or saunas prior to bedtime,
use the freezer to help calm the intensity of a flash.
Get Moving!
Regular exercise (at least 30 minutes three times a week) can also limit flashes, but evidence is limited to support this. However, the beneficial effects of exercise on bone density, cardiac health, and longevity are well documented.
Breathe!
Use paced respirations, which is a relaxation technique that can lessen both the incidence and intensity of hot flashes by 50%. Here's how:
Inhale deeply, exhale slowly while counting to 10.
Repeat 8-10 times per minute for 15 minutes.
Do this twice daily.
This can also be used at the onset of a flash to lessen its intensity.
Consider Alternative Therapies, but Be Careful!
Acupuncture can be very helpful, and small studies to date suggest it is helpful.
Yoga has no scientific proof that it can be beneficial, but some women swear by it to lessen flashes and improve their quality of life.
Other approaches that remain without sufficient study or evidence include: hypnosis, reflexology, reiki, massage, and so on. However, such approaches have little or no harm/risk involved so are worth trying.
The use of soy for hot flashes remains controversial, as studies are contradictory. Until more research is done, the safe recommendation is 2-4 servings a week, especially if there is a history of breast cancer.
Studies show vitamin E at 800 IU a day only decreased flashes by one less than a placebo, so this is not generally considered helpful. However, some women swear by it to lessen their flashes.
Herbal preparations like dong quai, ginseng, and black cohosh remain understudied, and we have little information on their effects on hot flashes, or, of more concern, their effect on recurrence risk for women with a breast cancer history.
Consider Drugs That Aren't Hormones
Medications that can help, but require a prescription include:
Effexor (venlafaxine, and the first-line drug at present), an antidepressant
Paxil or Prozac, selective serotonin reuptake inhibitors
Clonidine, which affects levels of blood chemicals
Bellergal, the only non-hormonal drug specifically approved for hot flashes and other menopausal symptoms. This drug contains phenobarbital and belladonna and can be addictive. It relieves symptoms about half the time.
Each has its own side effects, and use of these products necessitates a discussion and prescription from your doctor.
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