The Association of Minimally Invasive
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Gynecologic Surgeons
…dedicated to healthy lifestyles and safe, state-of-the-art, innovative surgery for women of all ages
ALTERNATIVE CHOICES FOR HOT FLUSHES
HERBAL THERAPIES
Herbal therapies are becoming popular. The best studied products have soy protein and/or black cohosh in
them. Popular combination products include promensil, remifinen, and estroven. Health food stores (GNC,
Wild Oats, Whole Foods) have many combination products Ingredients in these products usually consist of
dong quai, black cohosh, blue cohosh, wild yam root, soy, occasionally vitamin E, sometimes evening of
primrose oil and Siberian ginseng. These products are associated with menopause symptom management
(most have not been researched and proven to be of benefit). We have been involved in two randomized
trials looking at soy and black cohosh, principally, and their effect on hot flushing and other menopause
symptoms. Approximately 50% of participants showed improvement in their hot flushes.
NUTRITION AND DIET
Eating foods high in plant estrogens, such as soy beans and soy products, lima beans, and sweet
potatoes, may ameliorate symptoms. Other sources include nuts, seeds, fennel, celery, parsley, and flaxseed
oil.
Vitamins E and C can also help with flushes. Generally speaking 1000 IU Vitamin E and 1000 mg of
vitamin C is recommended. Remember Vitamin E can thin the blood.
AT HOME REMEDIES
1. Wear clothing made of cotton or other natural fibers and dress in loose layers.
2. Keep your house cool and use lightweight blankets at night.
3. Limit you intake of red wine, chocolate, aged cheese, and hot drinks.
4. Avoid smoking, caffeine, and excessive alcohol intake.
5. Avoid environments with extremes of temperature.
6. Avoid excessive stress.
MEDICATIONS
1. Catapres TTS (anti-hypertensive skin patch): 0.1mg patch changed weekly. May cause hypotension
(low blood pressure).
2. Bellergal (sedative): old fashion treatment for night flushes. (SE: drowsiness)
3. Effexor (anti-depressant) 37.5 mg two times/day
ALTERNATIVES TO VAGINAL DRYNESS
1. Replens vaginal moisturizer: apply 2x/week in the morning (others: gynogel, gynemoistrin)
2. Vitamin E capsules: break open and apply to the vagina as needed.
3. Vagifem (estrogen tablets inserted into the vagina)
4. Estrogen vaginal cream (premarin, estrace, ortho-dienestrol): 1 gm once/twice per week
5. Estring (vaginal estrogen ring): 3 month intravaginal silicone ring
6. Lubricate during intercourse with astroglide.