This Drug Can Help Stop Hot Flashes Without Hormones

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For many menopausal women and breast cancer survivors, hot flashes are par for the course.
They bring on sudden feelings of intense warmth, typically around the face, neck, and chest. They can be extremely uncomfortable and cause fatigue, irritability, and lack of focus during the day.
Hormone replacement therapy has long been considered to be the most effective way to manage hot flashes. However, for many women hormone therapy is not an option.
Women with certain medical histories, especially breast cancer survivors and those with a history of blood clots, are not recommended to get hormone therapy.
Now, women have another treatment option to treat their hot flashes, according to researchers from the Mayo Clinic.
New research suggests the drug oxybutynin effectively reduces the frequency and intensity of hot flashes in women who cannot take hormone replacement therapy, according to presenters at the 2018 San Antonio Breast Cancer Symposium early December.
Oxybutynin significantly lessens the intensity of hot flashes
To measure the effectiveness of oxybutynin, the researchers studied 150 women who had experienced at least 28 hot flashes per week for at least a month. The women were then randomized and received either 2.5 mg of oxybutynin twice a day, 2.5 mg twice a day for a week with a subsequent increase to 5 mg twice a day, or a placebo.
The group then completed weekly questionnaires that included details about their hot flashes and overall quality of life.
The research team found that the women who took oxybutynin experienced significantly fewer hot flashes than the women who took the placebo.
Furthermore, the women on both oxybutynin doses reported improvements in their overall quality of life — specifically with sleep, work, leisure activities, and social activities.
Oxybutynin reduces the muscle spasms that cause sweating
Oxybutynin is not a new drug. The medication has actually been around since the 1970s and was traditionally used to treat bladder incontinence.
“We have known for many years from observational reports that it seems to reduce sweating but this is the first study which evaluated this claim in a prospective clinical trial,” Dr. Steve Vasilev, a gynecologic oncologist and medical director of Integrative Gynecologic Oncology at John Wayne Cancer Institute at Providence Saint John’s Health Center, said.
Although doctors do not completely understand what causes hot flashes, they may be related to blood vessels near the skin spasming and then widening in an unregulated way. This causes higher blood flow at the skin and, therefore, heat and sweating, according to Vasilev.
Oxybutynin is an anti-cholinergic agent, which helps inhibit neurotransmitters in the brain. It works by reducing these spasms in the muscle cells that are located within the blood vessels, which ultimately reduces sweating.
It can be used by breast cancer survivors
Hormone replacement therapy — which uses estrogen and progesterone to stabilize hormone levels — has been the mainstay for treating hot flashes.
Unfortunately, breast cancer survivors cannot take hormone replacement therapy. Estrogen can cause breast cancer to develop and proliferate in those who have estrogen receptor-positive tumors.
“For patients who have a history of cancer (breast, uterine), thrombotic disease (blood clots), cardiac or liver disease, or who have had a stroke — these treatments are contraindicated,” Dr. Kecia Gaither, a double board-certified physician in OB/GYN and Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln, said.
Given the findings from this study, oxybutynin may offer certain patients another viable option for treating their hot flashes, Gaither added.
“The COSMOS trial is a large study population and a large clinical trial. We are about halfway through the trials now… and in 2021 we will be able to report results.”
Manson stressed that we are not ready to definitively say exactly how beneficial cocoa flavanols could be for your health. She said that the early research indicates that they could be helpful for cognitive function and reducing the risk of heart disease.
“There is some research going on at Columbia, and we are actually collaborating with them. I would say, in two to three years, we will have a good handle on the health benefits, the health effects of cocoa flavanols,” she added.
Manson said that we should all wait for the results of the study to fully assess just how impactful flavanols, derived from chocolate, can be on a person’s health.