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• W2077683844 abstract "The highly publicized findings of the Women's Health Initiative1Writing Group for the Women's Health Initiative Investigators Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial.JAMA. 2002; 288: 321-333Crossref PubMed Scopus (13969) Google Scholar, 2Women's Health Initiative Steering Committee Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women's Health Initiative randomized controlled trial.JAMA. 2004; 291: 1701-1712Crossref PubMed Scopus (4139) Google Scholar have increased the pressure on the medical community to find safe and alternative medications for female health, especially for hot flashes. Hot flashes are a common symptom experienced by postmenopausal women. In their severest form, hot flashes result in sleep deprivation and mood disorders. Women from varying ethnic backgrounds experience menopause in different ways. As a result, many studies have focused on hot flashes as a definable, yet subjective end point to test efficacy of various drugs, behavioral therapies, and herbal preparations. In this issue of the Mayo Clinic Proceedings, Miller and Li3Miller HG Li RM Measuring hot flashes: summary of a National Institutes of Health workshop.Mayo Clin Proc. 2004; 79: 777-781PubMed Scopus (89) Google Scholar provide the conclusions of a workshop on methods used to define hot flashes in an objective manner. The physiology of hot flashes is poorly understood. The issues surrounding our lack of understanding of the biology of hot flashes include the fact that methods to measure appropriate end points are inadequate. These measurements and defined end points are important because the placebo effect in the amelioration of hot flashes is substantial, as high as 50% in some studies. Many studies have assessed hormonal levels in postmenopausal women and have attempted to correlate the results with hot flashes. No relationship has been found among concentrations of estradiol, follicle-stimulating hormone, or luteinizing hormone and hot flashes.4Abe T Furuhashi N Yamaya Y Wada Y Hoshiai A Suzuki M Correlation between climacteric symptoms and serum levels of estradiol, progesterone, follicle-stimulating hormone, and luteinizing hormone.Am J Obstet Gynecol. 1977; 129: 65-67Abstract Full Text PDF PubMed Scopus (38) Google Scholar, 5Freedman RR Norton D Woodward S Cornelissen G Core body temperature and circadian rhythm of hot flashes in menopausal women.J Clin Endocrinol Metab. 1995; 80: 2354-2358Crossref PubMed Google Scholar Normally, body temperature is maintained within a specific thermoregulatory zone through vasodilatation and perspiration. During menopause, this thermoregulatory zone is narrowed, resulting in less tolerance to changes in core temperature. The reduced thermoregulatory zone is associated with increased sweating, resulting in discomfort.6Notelovitz M Hot flashes and androgens: a biological rationale for clinical practice.Mayo Clin Proc. 2004; 79: S8-S13PubMed Google Scholar There is little doubt that estrogen is a potent inhibitor of hot flashes.7Nelson HD Commonly used types of postmenopausal estrogen for treatment of hot flashes: scientific review.JAMA. 2004; 291: 1610-1620Crossref PubMed Scopus (201) Google Scholar Many studies have shown the efficacy of estrogen for attenuation of hot flashes, and estrogen remains the gold standard for the treatment of hot flashes. However, women are reluctant to take estrogen and physicians are reluctant to recommend hormone therapy because of the recent findings from the Women's Health Initiative. As a result, many women and physicians are seeking alternatives to estrogen for the amelioration of hot flashes. Progestogens and androgens have successfully attenuated hot flashes, and each has a definite adverse-effect profile that can limit the dose used. Studies of the physiology of hot flashes have revealed an association with increased norepinephrine levels in the preoptic hypothalamus in the brain. Serotonin destabilizes the thermoregulatory zone set point. The withdrawal of estrogen disrupts the balance between 2 different serotonin receptor types. This mechanism of action provides the rationale for the use of selective serotonin reuptake inhibitors (SSRIs) for hot flashes. The SSRI venlafaxine is an antidepressant that inhibits both norepinephrine and serotonin reuptake. At lower doses, the predominant effect is to inhibit serotonin reuptake, and at higher doses, norepinephrine reuptake is altered. Several placebo-controlled studies have shown that low-dose venlafaxine reduces hot flashes up to 61% compared with a reduction of 27% with placebo.8Barton D La VB Loprinzi C Novotny P Wilwerding MB Sloan J Venlafaxine for the control of hot flashes: results of a longitudinal continuation study.Oncol Nurs Forum. 2002; 29: 33-40Crossref PubMed Scopus (73) Google Scholar Fluoxetine, another SSRI, reduced hot flash scores by 50% compared with a 36% reduction with placebo.9Loprinzi CL Sloan JA Perez EA et al.Phase III evaluation of fluoxetine for treatment of hot flashes.J Clin Oncol. 2002; 20: 1578-1583Crossref PubMed Scopus (452) Google Scholar In that trial, women with breast cancer were recruited, many of whom were taking a selective estrogen receptor modulator (SERM), which may or may not have altered the effect because these compounds can precipitate hot flashes. However, no differential effects were noted in patients taking SERMs compared with those who were not taking SERMs. Trials with paroxetine, another SSRI, also reported a reduction in hot flashes. In a randomized, double-blind, placebo-controlled trial, the median reduction in hot flash frequency was 65% compared with a 38% reduction in hot flash scores with placebo.10Stearns V Beebe KL Iyengar M Dube E Paroxetine controlled release in the treatment of menopausal hot flashes: a randomized controlled trial.JAMA. 2003; 289: 2827-2834Crossref PubMed Scopus (436) Google Scholar In aggregate, these clinical trials suggest that the serotonin receptor may mediate in part the hyperthermic effect that occurs with hot flashes. The use of plant phytoestrogens for menopausal symptoms has a long history that reflects the effects of these compounds on estrogen-responsive target tissues. The most commonly used plant phytoestrogens are the isoflavones that are derived from soy or red clover. These estrogen-like compounds have been tested in capsule form or incorporated into food to diminish hot flash frequency and severity. Recent placebo-controlled clinical trials have indicated that these agents are no better than placebo in the treatment of hot flashes.11Vincent A Fitzpatrick LA Soy isoflavones: are they useful in menopause?.Mayo Clin Proc. 2000; 75: 1174-1184Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar, 12Fitzpatrick LA Selective estrogen receptor modulators and phytoestrogens: new therapies for the postmenopausal woman.Mayo Clin Proc. 1999; 74: 601-607Abstract Full Text Full Text PDF PubMed Scopus (62) Google Scholar, 13Fitzpatrick LA Alternatives to estrogen.Med Clin North Am. 2003; 87: 1091-1113Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar Three recently published clinical trials confirm this impression.14Penotti M Fabio E Modena AB Rinaldi M Omodei U Vigano P Effect of soy-derived isoflavones on hot flushes, endometrial thickness, and the pulsatility index of the uterine and cerebral arteries.Fertil Steril. 2003; 79: 1112-1117Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar, 15Nikander E Kilkkinen A Metsa-Heikkila M et al.A randomized placebo-controlled crossover trial with phytoestrogens in treatment of menopause in breast cancer patients.Obstet Gynecol. 2003; 101: 1213-1220Crossref PubMed Scopus (148) Google Scholar, 16Tice JA Ettinger B Ensrud K Wallace R Blackwell T Cummings SR Phytoestrogen supplements for the treatment of hot flashes: the Isoflavone Clover Extract (ICE) Study: a randomized controlled trial.JAMA. 2003; 290: 207-214Crossref PubMed Scopus (278) Google Scholar One study14Penotti M Fabio E Modena AB Rinaldi M Omodei U Vigano P Effect of soy-derived isoflavones on hot flushes, endometrial thickness, and the pulsatility index of the uterine and cerebral arteries.Fertil Steril. 2003; 79: 1112-1117Abstract Full Text Full Text PDF PubMed Scopus (139) Google Scholar confirmed the high rate of success with placebo, which reduced hot flashes by 40%, a value that was equivalent to the rate of reduction in hot flashes with isoflavones. These results in which placebo provides the same protection as the active agent emphasize the need for appropriate trial design. Black cohosh, or Cimicifuga racemosa, is an herbal product that was used originally as an insect repellent by Native Americans. This herb was the major ingredient (along with a hefty amount of alcohol) in Lydia E. Pinkhams's vegetable compound that was popular at the turn of the century for female problems. Black cohosh has been approved by the German E Commission for menopausal symptoms and painful menstruation.17Blumenthal M Klein S The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council, Boston, Mass1998Google Scholar Guidelines from the American College of Obstetricians and Gynecologists support the use of black cohosh for up to 6 months.18American College of Obstetricians and Gynecologists Web site.Available at: www.acog.orgGoogle Scholar The active ingredient in the root extract is thought to be the terpene glycoside fraction, including actein and cimifugoside. The rhizome contains other potentially biologically active substances, including alkaloids, flavonoids, and tannins. The major issue with black cohosh is the numerous preparations on the market; each one is extracted and isolated by a slightly different method. This is one reason why some studies claim that the root extract works independent of the estrogen receptor, whereas other studies find estrogen receptor–dependent actions.13Fitzpatrick LA Alternatives to estrogen.Med Clin North Am. 2003; 87: 1091-1113Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar This also explains the differences in clinical trial results that vary with the preparation. Black cohosh is recommended for sleep disturbances, mood disorders, and hot flashes. Most of the evidence to support these recommendations is from open-label trials, which are fraught with problems due to the placebo effect. In a randomized trial, breast cancer survivors were stratified according to tamoxifen use and then randomized to black cohosh or placebo.19Jacobson JS Troxel AB Evans J et al.Randomized trial of black cohosh for the treatment of hot flashes among women with a history of breast cancer.J Clin Oncol. 2001; 19: 2739-2745Crossref PubMed Scopus (335) Google Scholar Both the treatment and the placebo groups reported declines in the number and intensity of hot flashes. However, there was no statistically significant difference between the 2 groups, once again emphasizing the importance of a placebo arm in the trial design. Other herbal preparations have been tested for their ability to lessen symptoms associated with menopause. Dong quai, a Chinese herbal preparation, had no effect on hot flashes in a well-designed trial.20Hirata JD Swiersz LM Zell B Small R Ettinger B Does dong quai have estrogenic effects in postmenopausal women? a double-blind, placebo-controlled trial.Fertil Steril. 1997; 68: 981-986Abstract Full Text PDF PubMed Scopus (208) Google Scholar St John's wort, which is marketed for mood disorders, inhibited climacteric symptoms in an observational trial; however, proper placebo-controlled trials are important before this herbal preparation can be recommended. Ginseng had no effect on climacteric symptoms in a placebo-controlled trial.13Fitzpatrick LA Alternatives to estrogen.Med Clin North Am. 2003; 87: 1091-1113Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar Many agents have been unsuccessful in attenuating hot flashes in properly designed trials or have not been tested properly. Vitamin E,21Barton DL Loprinzi CL Quella SK et al.Prospective evaluation of vitamin E for hot flashes in breast cancer survivors.J Clin Oncol. 1998; 16: 495-500Crossref PubMed Scopus (345) Google Scholar yam cream, Vitex agnus-castus, naloxone, propranolol, and acupuncture22Wyon Y Lindgren R Lundeberg T Hammar M Effects of acupuncture on climacteric vasomotor symptoms, quality of life, and urinary excretion of neuropeptides among postmenopausal women.Menopause. 1995; 2: 3-12Crossref Scopus (123) Google Scholar have been unsuccessful in reducing hot flashes in clinical trials to date. No trials have reviewed homeopathic drugs or combination herbal preparations. In a placebo-controlled trial13Fitzpatrick LA Alternatives to estrogen.Med Clin North Am. 2003; 87: 1091-1113Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar using magnetic therapy, the placebo arm had a statistically better reduction in hot flashes, emphasizing the need for placebo control. Regarding pharmaceutical agents, Bellergal-S has been approved by the Food and Drug Administration as nonhormonal treatment of hot flashes. This preparation contains ergotamine tartrate, belladonna alkaloids, and phenobarbital (40 mg) and is classified as an autonomic nervous system stabilizer. In a placebo-controlled trial,23Lebherz TB French L Nonhormonal treatment of the menopausal syndrome: a double-blind evaluation of an autonomic system stabilizer.Obstet Gynecol. 1969; 33: 795-799PubMed Google Scholar Bellergal reduced hot flashes by 42% compared with placebo, but the potential for addiction limits its use. Veralipride is an antidopaminergic agent with antigonadotropic activity. In a double-blind, randomized study, veralipride was compared to a high dose of conjugated estrogens (1.25 mg); efficacy for hot flashes was equal.24Wesel S Bourguignon RP Bosuma WB Veralipride versus conjugated oestrogens: a double-blind study in the management of menopausal hot flushes.Curr Med Res Opin. 1984; 8: 696-700Crossref PubMed Scopus (25) Google Scholar The adverse effects of galactorrhea, elevated prolactin levels, and weight gain of 5 kg limit use of veralipride in clinical practice. The α2-adrenergic agonists reduce hot flashes due to alteration of hypothalamic neurotransmitters and stabilization of the thermoregulatory center. Clonidine is the most commonly used agent in this category. In 1 study, use of clonidine reduced the frequency of hot flashes by 30% to 50%, but it is less potent than estrogen.25Nagamani M Kelver ME Smith ER Treatment of menopausal hot flashes with transdermal administration of clonidine.Am J Obstet Gynecol. 1987; 156: 561-565Abstract PubMed Google Scholar Placebo and dropout rates have been high in trials of α2-adrenergic agonists because the adverse effects of sedation and dry mouth are difficult to tolerate. Gabapentin is a γ-aminobutyric acid analog that may attenuate hot flashes through another mechanism. In a double-blind, randomized, crossover trial, gabapentin had a favorable effect on the reduction of hot flashes compared with placebo.26Guttuso Jr, T Kurlan R McDermott MP Kieburtz K Gabapentin's effects on hot flashes in postmenopausal women: a randomized controlled trial.Obstet Gynecol. 2003; 101: 337-345Crossref PubMed Scopus (302) Google Scholar Behavioral therapies have been studied and have a modest effect on hot flashes. Paced respiration, relaxation techniques, and exercise have been tested in postmenopausal women, with mild attenuation of hot flashes. Certainly, many of these therapies are noninvasive and can be incorporated into a healthy lifestyle. Other recommendations that individual women find useful include avoidance of spicy food, caffeine, and alcohol; keeping ambient temperature low; and wearing layered clothing. Smoking cessation and an exercise program are highly recommended. A daily diary may be useful to assess triggers of hot flashes so that lifestyle can be modified to reduce intensity or incidence. Increasing our understanding of hot flash pathophysiology and defining better measures to assess the number and intensity of hot flashes will provide the basis for testing new agents with fewer adverse effects. With the “graying” of the population and more women entering their menopausal years, it is critical that new options become available to ease the distress associated with hot flashes. Measuring Hot Flashes: Summary of a National Institutes of Health WorkshopMayo Clinic ProceedingsVol. 79Issue 6PreviewVasomotor symptoms, including hot flashes and night sweats, are the most frequently reported symptoms of the menopausal transition. Although prevalence rates vary substantially across populations of menopausal women, the vast majority of women in the United States will experience hot flashes at some point during menopause. Other groups of people also experience hot flashes, including breast cancer survivors and men undergoing androgen deprivation therapy. Full-Text PDF" @default.
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• W2077683844 title "Menopause and Hot Flashes: No Easy Answers to a Complex Problem" @default.
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• W2077683844 cites W1970769902 @default.
• W2077683844 cites W1973757681 @default.
• W2077683844 cites W1975800838 @default.
• W2077683844 cites W1982012975 @default.
• W2077683844 cites W1983514713 @default.
• W2077683844 cites W1999727213 @default.
• W2077683844 cites W2024862998 @default.
• W2077683844 cites W2029774344 @default.
• W2077683844 cites W2030888554 @default.
• W2077683844 cites W2044267303 @default.
• W2077683844 cites W2061166082 @default.
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• W2077683844 cites W2085008522 @default.
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• W2077683844 cites W2417384717 @default.
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