7 May 2015:
The European Menopause and Andropause Society (EMAS) has published a position statement covering non-hormonal management of menopausal vasomotor symptoms.
Hot flushes are a common menopausal symptom. They tend to intensify during the perimenopause and usually subside within five years after the final menstrual period. However in some women frequent hot flushes are a long term problem and may last for more than seven years.
While estrogen-based menopausal hormone therapy is the most effective treatment it is not indicated for all women, such as those with a personal history of breast cancer.
The position statement provides a practical guide to non-hormonal management.
It covers lifestyle modifications, diet and food supplements, non-hormonal medications and use of behavioral and alternative medicine therapies. The key conclusions are that
- There is insufficient or conflicting evidence to suggest that exercise, supplements or a diet rich in phytoestrogens are effective for hot flushes.
- Selective serotonin-reuptake inhibitors (SSRIs), serotonin norepinephrine-reuptake inhibitors (SNRIs) and gabapentin could be proposed as alternatives to estrogen-based therapies.
- Behavioral therapies and alternative medicine interventions have been tried, but the available evidence is still limited.
Thus women who cannot take estrogens should be able to discuss non-hormonal options with their health professional.
Mintziori G, Lambrinoudaki I, Goulis DG, Ceausu I, Depypere H, Erel CT, Pérez-López FR, Schenck-Gustafsson K, Simoncini T, Tremollieres F, Rees M. EMAS position statement: Non-hormonal management of menopausal vasomotor symptoms. Maturitas. 2015 Apr 22. pii: S0378-5122(15)00649-0. doi: 10.1016/j.maturitas.2015.04.009. [Epub ahead of print]