Some Women May Need More Hormone Therapy

By Jane Farrell

Researchers have found that for a substantial percentage of women, moderate to severe hot flashes last up to ten years or more after menopause, and that may mean hormone therapy should be prescribed for a longer period of time.

Investigators from the University of Pennsylvania’s Perelman School of Medicine discovered that for most women, moderate to severe hot flashes continue, on average, for just five years after menopause, but more than one third of women have hot flashes for a decade or beyond.

Current guidelines recommend that hormone therapy, the primary medical treatment for hot flashes, stop after five years. But in a study published in the journal Menopause, the authors wrote that empirical evidence for that time limitation is lacking.

Hot flashes are episodes of intense radiating heat experienced by many women around the time of menopause. Because changing hormone levels are believed to cause hot flashes as well as other symptoms such as irritability and anxiety, hormone therapy is often prescribed.

But the therapy isn’t appropriate for all women, and some health hazards linked to HRT, such as increased risk of some cancers, have made doctors less likely to prescribe it, or to prescribe it in accordance with the recommended length of time.

While hormone replacement therapy (HRT) is considered the most effective treatment for hot flashes, it is not appropriate for all women. In addition, concerns about health hazards linked to HRT have made some doctors less likely to prescribe it, or to adhere strictly to recommended duration guidelines.

The study evaluated 255 women in the Penn Ovarian Aging Study who reached natural menopause over a 16-year period (1996-2012). Eight percent of the women reported moderate to severe hot flashes, while 17 percent had mild ones, and three percent reported non.

The results indicate that 80 percent (203) reported moderate/severe hot flashes, 17 percent (44) had only mild hot flashes, and three percent (8) reported no hot flashes. Obese white and African-American women had the greatest risk of moderate to severe hot flashes.