Treatment of menopausal hot flashes with transdermal administration of clonidine.
ABSTRACT A randomized prospective double-blind study was performed to evaluate the efficacy of a transdermal therapeutic system delivering clonidine in the treatment of menopausal hot flashes. Frequency, severity and duration of the flushing attacks before and during the 8-week treatment period were evaluated. The reduction in the number of hot flashes was highly significant in patients receiving the clonidine transdermal therapeutic system. On subjective comparison of flushing attacks before and during treatment, of the 15 patients who received the clonidine transdermal therapeutic system, 80% reported fewer hot flashes; 73% a decrease in severity; and 67% a decrease in duration. Among the 14 patients who were treated with placebo only, 36% reported fewer hot flashes; 29% a decrease in severity; and 21%, shorter duration (frequency, p less than 0.04; severity, p less than 0.04; and duration, p less than 0.03). Reported side effects were minimal, and no significant effect was observed on blood pressure or pulse rate. Transdermal clonidine therapy had no effect on the pulsatile luteinizing hormone secretion.
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ABSTRACT: Hot flashes (HFs) are a rapid and exaggerated heat dissipation response, consisting of profuse sweating, peripheral vasodilation, and feelings of intense, internal heat. They are triggered by small elevations in core body temperature (Tc) acting within a greatly reduced thermoneutral zone, i.e., the Tc region between the upper (sweating) and lower (shivering) thresholds. This is due in part, but not entirely, to estrogen depletion at menopause. Elevated central sympathetic activation, mediated through α2-adrenergic receptors, is one factor responsible for narrowing of the thermoneutral zone. Procedures which reduce this activation, such as paced respiration and clonidine administration, ameliorate HFs as will peripheral cooling. HFs are responsible for some, but not all, of the sleep disturbance reported during menopause. Recent work calls into question the role of serotonin in HFs.The Journal of steroid biochemistry and molecular biology 09/2013; · 3.98 Impact Factor
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ABSTRACT: Background According to the current recommendations, women with post-menopausal symptoms should be managed. Knowledge and perception of primary care physicians towards management of postmenopausal symptoms are deficient.AimThe aim of the present study was to explore knowledge and attitude of primary care doctors towards management of postmenopausal symptoms.Methods This study is a cross-sectional survey that was conducted from October to December 2010 in the five health regions in Kuwait. Two centers were selected randomly from each health region. All physicians who were currently working in the selected centers were asked to participate in the study. Out of 209 physicians, 142 agreed to participate and completed a self-administered questionnaire.ResultsThe study revealed that 82.4% of physicians had moderate knowledge about treatment options for postmenopausal symptoms, 88.0% discussed postmenopausal symptoms with their patients, and 45.1% of them either described or referred their patients for hormonal replacement therapy (HRT). The correct answers regarding 10 statements related to the Women Health Initiative finding were ranging from 2.8% to 78.9% which indicated low level of knowledge. Regarding the effectiveness of hormonal replacement therapy in postmenopausal women, the majority of the physicians agreed correctly that HRT is effective in prevention of osteoporosis (87.3%), treatment of vasomotor symptoms (83.7%), and treatment of vulvo-vaginal symptoms (82.4%). There was a variation among physicians opinion about the effectiveness of certain treatment options for managing hot flushes in postmenopausal women.Conclusion The results suggest that there is a lack of primary care physicians knowledge and confidence in recognizing signs and symptoms of menopause and in identifying and prescribing appropriate management.Alexandria Journal of Medicine. 06/2012; 48(2):167–173.