How effective are other drugs in treating menopausal flushes?
Nothing is as effective as HRT in treating vasomotor symptoms. Clonidine, an a-adrenoceptor agonist used for the treatment of hypertension, has been used for the relief of hot flushes but there have been no satisfactory randomised trials that show it to be as effective or of value. There is evidence that SSRIs such as venlafaxine, paroxetine and fluoxetine are effective in controlling hot flushes but there is insufficient evidence to support long-term use. Gabapentin, more commonly used as an anti-epileptic or for the treatment of neurogenic pain, is effective but side-effects may preclude its use. Progestogens are effective and megestrol acetate has been used widely in women with breast cancer. Its mode of action might be due to conversion into oestrogen by the body. Long-term studies have not been carried out. Dihydroepiandrostenedione (DHEA) is marketed in the US and on the internet as an anti-ageing agent. It has no known use at the menopause. Progesterone transdermal creams are no
