Hot flushes and night sweats

Hot flushes or hot flashes can be one of the most disruptive symptoms. These sudden feelings of heat can make you sweat and feel uncomfortable and can occur during the day and night.

Some people also experience cold flushes, which feel like sudden chills instead of heat. In many cases, flushes can come with other symptoms like a palpitations or dizziness, which can make the whole experience feel quite unsettling and uncomfortable.

Here are some non-medical ways to manage them:

• Dress in layers so you can remove clothing when you feel a flush coming on.
• Stay cool with a fan, cool drinks, or by using cooling aids like gel packs.
• Identify and avoid your triggers like spicy foods, caffeine, or alcohol, which can sometimes make hot flushes worse.
• Practice relaxation techniques like deep breathing or mindfulness to reduce stress, which can also trigger hot flushes.
• Some people explore alternative therapies like acupuncture, hypnosis, or homeopathy. While these may offer relief for some, it’s important to know that scientific evidence supporting them is still limited.

For people who need medical support in addition to the practical tips above, there are non-hormonal prescription medications that can help reduce hot flushes. The older medicines were all developed for other reasons but have been found to also help with hot flushes.

SSRIs or SNRIs which are classed as anti-depressant or anti-anxiety medications, also act on the temperature regulation centre of the brain to suppress hot flushes, night sweats, allay anxiety and improve mood.

Gabapentin and pregabalin, typically used for nerve pain or epilepsy, can also help by reduce the severity and duration of hot flushes by modulating neurotransmitter activity

Clonidine is an alpha-agonist, sometimes used to manage high blood pressure, but it can also help reduce hot flushes by affecting the brain’s regulation of body temperature.

Oxybutinin is typically used to treat bladder urgency but has been found to reduce hot flushes as well.

Newer medication options Elinzanetant and Fezolinetant, are medications that work by blocking specific receptors in the brain involved in regulating temperature and heat (neurokinin-3 (NK3) receptor).

Early studies show it may provide effective relief with fewer side effects compared to other treatments by targeting these receptors to reduce the frequency and severity of hot flushes.

These may be especially promising for people with hormone-sensitive cancers, such as breast cancer, who need to avoid traditional hormone therapy.

There are several medication options available, including newer treatments, which offer promising alternatives to traditional hormone therapies. However, it’s important to remember that the right medication for you depends on your unique medical history, including your cancer treatment history.

Always discuss your symptoms and treatment options with your healthcare provider to find the best and safest approach for managing your hot flushes.