Yes, hot flashes can last 15 years
DEAR DR. ROACH: I started going through natural menopause in my late 50s. I will be 65 in September. Should I still be having hot flashes? ANSWER: Unfortunately, some women (perhaps 25 per cent) will continue to have hot flashes 15 years out from the start of menopause.
There are many treatments for hot flashes, but although estrogens are the most effective, the risk of starting hormone replacement at age 65 is considerably higher than at age 50, so most clinicians are uncomfortable prescribing them.
Before thinking about medication, however, many women (and a few men, such as those on hormonal treatment for prostate cancer) have found non-medicinal ways to deal with them.
Layers of clothing are key — take extra layers off when hot, but recognize that so much body heat can be lost, a person actually can shiver when the flash is over.
Keeping the room cooler will help as well. Anyone living with you may just have to deal with that. Handheld fans are great for some.
Prescription medications include medicines normally used for depression (like venlafaxine, citalopram or paroxetine) and for seizures (gabapentin often is prescribed, especially if symptoms are worse at night).
Various supplements are used, but est rog en containing ones, even plan test rog ens, may have significant though poorly quantified risks.
A new class of medicines (NK3 inhibitors) still is being studied and may be very beneficial, but it seems like I’ve been saying that for a while now. Food and Drug Administration approval sometimes can take years.
DEAR DR. ROACH: In a recent column, you discussed the effect of ibuprofen on men with an enlarged prostate. I am a 78-year-old who runs 15-20 miles per week, with benign prostatic hyperplasia and who also has reduced urinary frequency with occasional use of Advil. As a runner, I have been reluctant to make it a daily regimen because I have read that inflammation is part of the body’s response to tissue damage, which is crucial to the healing process and is important for muscle growth.
When ibuprofen’s anti-inflammatory effect reduces symptoms, does it affect the healing process also? Can you comment on the pros and cons for runners?
ANSWER: High-dose ibuprofen was shown to inhibit muscle protein synthesis following weightlifting exercise. This led to a suspicion that it might impair the gains in muscle strength that are made with exercise.
However, a Canadian study showed that moderate doses of ibuprofen (400 mg after exercise) did not impair muscle growth or gains in strength.
Using ibuprofen for occasional muscle soreness or for the purpose of reducing prostate inflammation should not adversely affect your performance in running.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth @med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.