For many menopausal women and breast cancer survivors, hot flashes are par for the course.
They bring on sudden feelings of intense warmth, typically around the face, neck, and chest. They can be extremely uncomfortable and cause fatigue, irritability, and lack of focus during the day.
Hormone replacement therapy has long been considered to be the most effective way to manage hot flashes. However, for many women hormone therapy is not an option.
Women with certain medical histories, especially breast cancer survivors and those with a history of blood clots, are not recommended to get hormone therapy.
Now, women have another treatment option to treat their hot flashes, according to researchers from the Mayo Clinic.
New research suggests the drug oxybutynin effectively reduces the frequency and intensity of hot flashes in women who cannot take hormone replacement therapy, according to presenters at the 2018 San Antonio Breast Cancer Symposium early December.
Oxybutynin significantly lessens the intensity of hot flashes
To measure the effectiveness of oxybutynin, the researchers studied 150 women who had experienced at least 28 hot flashes per week for at least a month. The women were then randomized and received either 2.5 mg of oxybutynin twice a day, 2.5 mg twice a day for a week with a subsequent increase to 5 mg twice a day, or a placebo.
The group then completed weekly questionnaires that included details about their hot flashes and overall quality of life.
The research team found that the women who took oxybutynin experienced significantly fewer hot flashes than the women who took the placebo.
Furthermore, the women on both oxybutynin doses reported improvements in their overall quality of life — specifically with sleep, work, leisure activities, and social activities.
Oxybutynin reduces the muscle spasms that cause sweating
Oxybutynin is not a new drug. The medication has actually been around since the 1970s and was traditionally used to treat bladder incontinence.
“We have known for many years from observational reports that it seems to reduce sweating but this is the first study which evaluated this claim in a prospective clinical trial,” Dr. Steve Vasilev, a gynecologic oncologist and medical director of Integrative Gynecologic Oncology at John Wayne Cancer Institute at Providence Saint John’s Health Center, said.
Although doctors do not completely understand what causes hot flashes, they may be related to blood vessels near the skin spasming and then widening in an unregulated way. This causes higher blood flow at the skin and, therefore, heat and sweating, according to Vasilev.
Oxybutynin is an anti-cholinergic agent, which helps inhibit neurotransmitters in the brain. It works by reducing these spasms in the muscle cells that are located within the blood vessels, which ultimately reduces sweating.
It can be used by breast cancer survivors
Hormone replacement therapy — which uses estrogen and progesterone to stabilize hormone levels — has been the mainstay for treating hot flashes.
Unfortunately, breast cancer survivors cannot take hormone replacement therapy. Estrogen can cause breast cancer to develop and proliferate in those who have estrogen receptor-positive tumors.
“For patients who have a history of cancer (breast, uterine), thrombotic disease (blood clots), cardiac or liver disease, or who have had a stroke — these treatments are contraindicated,” Dr. Kecia Gaither, a double board-certified physician in OB/GYN and Maternal Fetal Medicine at NYC Health + Hospitals/Lincoln, said.
Given the findings from this study, oxybutynin may offer certain patients another viable option for treating their hot flashes, Gaither added.
Some women may experience harmful side effects
Like any medication, oxybutynin has its side effects.
“The ‘anti-cholinergic’ effect means it can cause dry mouth, interfere with intestinal function, and, most importantly, can be a problem in patients with narrow angle glaucoma (an eye disorder),” Vasilev explained.
It can also be dangerous if mixed with other anti-cholinergic medications and some herbal supplements, Vasilev warned. It’s crucial to discuss your medications with your doctor before using oxybutynin.
Lastly, there’s some concern that oxybutynin may lead to cognitive decline. According to some health experts, it’s best to use the drug as a short-term solution.
When in doubt, avoid caffeine and manage your stress
In general, doctors recommend making a few lifestyle changes before starting any medications.
Try identifying what’s causing your hot flashes so you can avoid them. For example, spicy foods, alcoholic beverages, and cigarettes are known to trigger hot flashes in many women. If this is the case, try to eat a well-balanced diet and cut back on smoking.
Stress is also thought to be a major cause of hot flashes. Vasilev recommends exercising regularly and focusing on relaxation methods, such as yoga or meditation.
There is no one-size-fits-all method to managing hot flashes. Every body responds to treatments and methods differently.
Before starting a treatment plan, talk to your healthcare provider about your symptoms, medical history, and goals.
There are a lot of options out there for keeping hot flashes at bay, and your doctor can help you choose a path that’s ideal for you.
The bottom line
Women have another treatment option to treat their hot flashes in addition to hormone therapy, according to researchers from the Mayo Clinic.
This means women who have gone through breast cancer or have other medical conditions that keep them from hormone therapy have another option for relief.
The drug oxybutynin effectively reduces the frequency and intensity of hot flashes in women, suggests new research that was presented at the 2018 San Antonio Breast Cancer Symposium early December.