Chronic pain treatment cools hot flashes in menopausal women

"Hot flashes affect more than 80 percent of menopausal women," said David R. Walega, M.D., chief of the Division of Pain Medicine, and program director of the Multidisciplinary Pain Medicine Fellowship Department of Anesthesiology at Northwestern University Feinberg School of Medicine, Chicago. "This is the first effective, non-hormonal treatment for hot flashes, which for many women have a serious negative effect on their lives. This treatment will also help breast cancer patients who suffer from hot flashes as a side effect of their treatments or medication. Some breast cancer patients stop taking their medication (tamoxifen) because of hot flashes."

Hot flashes are a sudden feeling of heat or warmth starting in the face and extending to the neck and chest area. Some women also experience profuse sweating and a "reddening" or flush to their skin. Hot flashes can last anywhere from one to 10 minutes and vary in strength and frequency.

This prospective, randomized, controlled study included 40 patients between 30 and 65 years old who experienced at least 25 hot flashes per week. Half of the participants received a stellate ganglion blockade (SGB) injection with a local anesthetic. A SGB blockade was injected in the neck about two inches to the right of the voice box. The other 20 patients received an injection of sterile saline. The patients recorded the daily number of hot flashes in a journal and were followed for six months. The study participants were also objectively assessed by a Core Temperature Monitor, which measures changes in a person's skin conductants.

Moderate to severe hot flashes decreased 50 percent for women who received the SGB injection. Dr. Walega also observed a 30 percent decrease in depression and a 10 percent improvement in verbal learning. These findings were important as loss of memory and cognition are another frequent concern of women in menopause who have hot flashes.

"This is a fast, relatively painless, long-lasting and cost-effective treatment for hot flashes," continued Dr. Walega. "It has tremendous potential to help not only menopausal women, but also breast cancer patients and women in surgical menopause (whose ovaries have been removed), who have had to put up with ineffective treatments or simply 'grin and bear it.'"