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Managing vasomotor symptoms in women after cancer.
Climacteric 2019; 22(6):544-552C

Abstract

Women with estrogen-sensitive cancer or survivors of these neoplasms are generally not candidates for systemic menopausal hormone therapy or tibolone for the treatment of bothersome vasomotor symptoms (hot flashes or night sweats). However, menopausal symptoms negatively affect quality of life and need to be addressed by clinicians. For mild vasomotor symptoms, optimizing lifestyle changes or mind-brain behavior may be sufficient. For women with moderate to severe vasomotor symptoms unresponsive to these measures, non-hormone pharmacologic therapy may be needed. Randomized controlled trials have shown efficacy for vasomotor symptoms with selective serotonin reuptake inhibitors (paroxetine, citalopram, and escitalopram) and serotonin-norepinephrine reuptake inhibitors (venlafaxine and desvenlafaxine), as well as gabapentin, pregabalin, and clonidine. Therapies in development include neurokinin B inhibitors (neurokinin 3 receptor), stellate ganglion blockade, and a natural estrogen, estetrol. Individualizing therapy is important. As the physiology of menopausal hot flashes becomes better understood, it will drive development of future non-hormone pharmacotherapies.

Authors+Show Affiliations

Division of Midlife Health, University of Virginia Health System , Charlottesville , VA , USA.Division of Endocrinology and Metabolism, University of Virginia Health System , Charlottesville , VA , USA.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31081391

Citation

Pinkerton, J V., and R J. Santen. "Managing Vasomotor Symptoms in Women After Cancer." Climacteric : the Journal of the International Menopause Society, vol. 22, no. 6, 2019, pp. 544-552.
Pinkerton JV, Santen RJ. Managing vasomotor symptoms in women after cancer. Climacteric. 2019;22(6):544-552.
Pinkerton, J. V., & Santen, R. J. (2019). Managing vasomotor symptoms in women after cancer. Climacteric : the Journal of the International Menopause Society, 22(6), pp. 544-552. doi:10.1080/13697137.2019.1600501.
Pinkerton JV, Santen RJ. Managing Vasomotor Symptoms in Women After Cancer. Climacteric. 2019;22(6):544-552. PubMed PMID: 31081391.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Managing vasomotor symptoms in women after cancer. AU - Pinkerton,J V, AU - Santen,R J, Y1 - 2019/05/13/ PY - 2019/5/14/pubmed PY - 2019/5/14/medline PY - 2019/5/14/entrez KW - Non-hormone pharmacotherapies KW - clonidine KW - estetrol KW - gabapentin KW - hot flashes KW - menopause KW - neurokinins KW - selective serotonin reuptake inhibitor KW - serotonin–norepinephrine reuptake inhibitor SP - 544 EP - 552 JF - Climacteric : the journal of the International Menopause Society JO - Climacteric VL - 22 IS - 6 N2 - Women with estrogen-sensitive cancer or survivors of these neoplasms are generally not candidates for systemic menopausal hormone therapy or tibolone for the treatment of bothersome vasomotor symptoms (hot flashes or night sweats). However, menopausal symptoms negatively affect quality of life and need to be addressed by clinicians. For mild vasomotor symptoms, optimizing lifestyle changes or mind-brain behavior may be sufficient. For women with moderate to severe vasomotor symptoms unresponsive to these measures, non-hormone pharmacologic therapy may be needed. Randomized controlled trials have shown efficacy for vasomotor symptoms with selective serotonin reuptake inhibitors (paroxetine, citalopram, and escitalopram) and serotonin-norepinephrine reuptake inhibitors (venlafaxine and desvenlafaxine), as well as gabapentin, pregabalin, and clonidine. Therapies in development include neurokinin B inhibitors (neurokinin 3 receptor), stellate ganglion blockade, and a natural estrogen, estetrol. Individualizing therapy is important. As the physiology of menopausal hot flashes becomes better understood, it will drive development of future non-hormone pharmacotherapies. SN - 1473-0804 UR - https://www.unboundmedicine.com/medline/citation/31081391/Managing_vasomotor_symptoms_in_women_after_cancer_ L2 - http://www.tandfonline.com/doi/full/10.1080/13697137.2019.1600501 DB - PRIME DP - Unbound Medicine ER -