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Effective treatment of hot flushes with menopause: doctor's reviews

, medical expert
Last reviewed: 17.10.2021
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The question of what should be the effective treatment of hot flushes with menopause remains in the focus of attention of doctors and patients for more than a dozen years. And although all the physical symptoms of menopause are due to age-related changes in the functions of the ovaries (a reduction in the synthesis of sex steroids) and are a natural manifestation of the physiology of the female body, it is possible to reduce the inten- sity of unpleasant vasomotor symptoms of menopause-tides and nocturnal hyperhidrosis.

What is the basis for treatment of hot flushes with menopause?

In conditions of age involution of the ovaries, the treatment of hot flashes with menopause is based on "correction of hormonal imbalance," that is, on increasing the level of estrogen, although the number of membrane estrogen receptors in the tissues of the ovaries decreases with age, and their sensitivity.

Those who want to relieve the condition associated with climacteric tides, and curb sweating with menopause, it should be recalled that the production of estrogens is not commanded by the ovaries, but the hypothalamus with the pituitary: the hypothalamus produces special gonadotropic neurohormones - gonadoliberins. Under their influence, the pituitary gland produces FSH (follicle-stimulating hormone), LH (luteinizing hormone) and prolactin. FSH via the adenylate cyclase system transfers the amplified signal to the ovarian cell receptors, and they increase the production of estrogens in the follicles.

But, as the ovarian reserve of ovaries is exhausted during climax and their follicular apparatus is invoked, not only the synthesis of estradiol but also the hormone inhibin B, which is produced by the granular cells of the ovaries and suppresses the production of FSH in the pituitary gland, is reduced. Therefore, during the menopause, the content of FSH and LH in the blood of women is extremely high. How do they behave? After all, all hormones have not only individual, but also interrelated functions in the human body.

There are studies that show that FSH in women during the menopause acts on low-density lipoprotein receptors (LRP1, A2MR, APOER) in the brain, and these receptors are involved in the metabolism of lipids (and in women there is a significant increase in the mass of adipose tissue in the abdominal cavity ), in the regulation of vascular tone (in women in menopause increases blood pressure) and cholesterol, cell growth and cell migration, as well as neurodegenerative pathologies.

However, the synthesis of estrogens does not completely stop, just a minimum amount of estrone begins to be produced by aromatase P450 not in the ovaries, but in adipose tissue. As a paracrine hormone, estrone acts locally: on mesenchymal cells of adipose tissue, osteoblasts and chondrocytes of bone tissues, vascular endothelium and aortic smooth muscle cells, as well as numerous areas in the brain.

But the sympathetic nervous system reacts to all the hormonal changes in its own way - neurogenic arterial hyperemia, that is, the notorious tides that arise spontaneously when the receptors of such neurotransmitters as acetylcholine, adrenaline, noradrenaline are affected.

Tidal medications for menopause

Most gynecologists believe that the treatment of hot flushes with menopause is best done with the use of such herbal remedies as the multi-component homeopathic remedy Remens, which contains an extract of the roots of the plant Voronets or klopogon brush (Cimicifuga racemosa is a branch of phytoestrogens). This plant as an active substance is also used in medicines Climadinon, Climact, Qi-Klim and a sufficient number of various dietary supplements.

It should be borne in mind that tsimicifugi substances can cause headache, dizziness, nausea, vomiting, bradycardia. And British experts warn that prolonged use of extracts of this plant has a toxic effect on the liver and, in addition, may lead to a thickening of the mucous membrane of the uterus.

Tidal preparations for menopause may contain extracts of meadow (red) clover (Trifolium pratense), soybeans (due to the similarity to estrogen isoflavones genistin and genistein), as well as the extract of rhizome dioscorea (wild yam) or the root of Angelica sinensis.

Complete information on the drugs recommended by physicians for the treatment of climacteric tides, describing the active substances, methods of use, contraindications and side effects, in the article - Tablets from hot flushes with menopause

Can be used to treat hot flushes with menopause and other medicines. Thus, anticonvulsant Gabapentin (Gabantine, Gabagama, Gabalept and other trade names) helps to reduce the activity of neurons and reduces the excitation of the central and autonomic nervous system. The recommended dosing regimen is one capsule (300 mg) once a day. Among the possible side effects of this drug are increased blood pressure, increased heart rate, headache, tinnitus, fatigue, insomnia, etc.

Often, sedatives or antidepressants of the selective serotonin and norepinephrine reuptake inhibitors group help to reduce tidal flares: Paroxetine (Paroxetine hydrochloride, Paxil) 12.5-25 mg per day, or Venlafaxine (Effexor, Efetine, Fenetylamine) 37.5-75 mg in a day. However, both drugs can cause serious side effects in the form of lowering blood pressure, headaches and dizziness, tachycardia, drowsiness, general weakness, dry mouth, nausea, constipation, mucosal bleeding, increased blood cholesterol, decreased appetite, weight gain and etc.

So, it is much safer to take the usual tincture of hawthorn (20 drops twice a day) - if there is no diabetes mellitus, and also tincture of calendula officinalis - provided there is no arterial hypotension and stones in the bladder or kidneys).

Supplement the above information can material - Remedies for hot flashes with menopause

Treatment of hot flushes with menopause by alternative means

Recommended treatment for hot flushes with menopause by alternative means includes:

  • rubbing the skin with pieces of ice wrapped in cotton fabric;
  • application of peppermint oil on the back of the neck;
  • intake of linseed oil (dessert spoon a day).

It is also recommended to drink broths and water infusions of herbs: spring primrose (roots), sage (grass), oregano (grass), calendula (flowers), St. John's wort (grass). For broth, a tablespoon of dry raw material is poured into 1.5 cups of boiling water, boiled on low heat for 15 minutes, infused for about an hour (in a sealed container) and filtered.

Decoction of the primrose is drunk on a tablespoon 3-4 times a day, and sage (only if there are no acute kidney diseases) - a quarter cup (at meal time).

Decoction or infusion of oregano take a tablespoon three times a day; Calendula can be taken twice a day - 100 ml (contraindications - stones in the gallbladder). But St. John's wort should take three tablespoons 2-3 times a day, but it should be borne in mind that this plant contributes to a good appetite and causes an increased sensitivity of the skin to UV rays.

Treatment of hot flashes with menopause hormone replacement

With the obvious popularity of tidal treatment in menopause using drugs containing analogues of female sex hormones - esterified estrogen, ethinyl estriol and progesterone (in the form of a synthetic progestin) - there is no scientific evidence that would confirm the need of the female body after menopause for replenishment with exogenous sex steroids.

Moreover, hormone replacement therapy is not able to restore the level of sex hormones that exist before the onset of menopause with synthetic chemicals.

But antimycotic hormonal drugs can improve a woman's condition, that is, remove some manifestations of menopause and prevent possible complications.

Their names, mechanism of action, side effects, contraindications, dosage and drug interactions are detailed in the publication - Herbs for the relief of menopause

In recent years, several studies have shown that after hormone replacement therapy, the risk of developing breast cancer and cardiovascular diseases is increased. The largest study involving nearly 162,000 healthy postmenopausal women was conducted in the US by the Women's Health Initiative (WHI) under the auspices of the National Institutes of Health (NIH).

Before 2002, 6 million American women had treated the hot flushes with menopause, taking hormones, but after the publication of the results of this study, their number quickly fell by about half. The number of cases of diagnosed breast cancer also began to decline soon.

At the same time, according to The Journal of the American Medical Association, the frequency of breast cancer diagnosis increases with prolonged use of estrogen and, to a greater extent, with drugs with a combination of estrogen and progestin (progestagen). The results of mammography showed that in 36.2% of menopausal women taking sex hormones, the density of breast tissue increased, which required the use of biopsy and histological examination. This is explained by the fact that sex steroids can increase the proliferation of breast tissue, which is pathology.

Many doctors suggest that to reduce the symptoms of menopause, women can safely take hormones only for four to a maximum of five years.

Several years ago, the German medical journal Deutsches Arzteblatt International published an article by researchers at the Department of Obstretics and Gynecology of the University of Regensburg (Germany), in which it was noted that hormones can be used to treat menopausal symptoms only after extensive examination of patients, and also with their advantages and risks of such treatment. And it can not be recommended the widespread use of hormones by all women with menopausal symptoms, including hot flashes.

According to the latest report of Global Industry Analysts, Inc. (for May 2016), the demand in the world pharmaceutical market for hormone replacement therapy for menopause will grow by 8% in five years - to $ 3.5 billion. And all thanks to the fact that the population of the female population of climacteric age is growing, and many doctors offer them "to prolong youth" with the help of hormones.

Treatment of hot flushes with menopause: medical advice

Menopause is a natural part of a woman's life cycle. You can not prevent it, but it is very important to maintain a healthy lifestyle during the menopause. For example, doctors advise, first of all, to remove the most frequent triggers of hot flushes with menopause: alcohol, caffeine, spicy food, smoking; Clinging clothing made of synthetic fabrics, stay in stuffy rooms with high temperature.

Also, you need to eat properly and maintain a normal body weight, get enough sleep (the daily duration of sleep should be at least 7-8 hours), try not to be nervous, exercise regularly (best of all - outdoors), monitor blood pressure, take multivitamin preparations.

And only with ineffectiveness of all of the above, a gynecologist can prescribe tidal treatment with menopause and recommend drugs to ease menopause

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