Meds Making You Melt? Safer Relief for Hot Flashes
- Dr. K Derezil MD
- Feb 27, 2024
- 4 min read
Ladies, if menopause has turned up the heat leaving you miserable from raging hot flashes and night sweats, you’re not alone! Up to 80 percent of midlife women deal with roasting, drenched misery compliments of wonky hormones and faulty internal thermostats.
But besides estrogen taking an early retirement, guess what else might fan the flames of your fiery personal summers? Surprisingly, a number of common prescription and over-the-counter medications can rev up the intensity and frequency of hot flashes. Like we need ANYTHING making them worse, right?!
As your friendly neighborhood women’s health specialist armed with wit and wisdom, I’ll walk you through the drug culprits linked to hot flash hell — along with safer alternatives easing symptoms so you can stop suffering in silence!
SSRIs & Hot Flashes: Trouble Ahead!
You’ve likely seen commercials for popular antidepressants called SSRIs (selective serotonin reuptake inhibitors) like Zoloft, Prozac and Paxil touting restored joy for depression and anxiety. But evidence confirms that for menopausal women, SSRI use significantly worsens hot flash severity for up to HALF of patients![1]
Why the heat wave? Researchers hypothesize SSRIs alter hypothalamic signaling and block nitric oxide triggering temperature dysregulation — essentially throwing your inner thermostat completely out of whack. [2] No thanks!
While SSRIs work wonders for some midlife women’s mood disorders, their tendency to crank up the heat makes me advise patients to avoid this class initially when battling bothersome flashes. Instead, I guide women toward safer first line options like cognitive behavior therapy, behavioral activation therapy, regular exercise, or short-acting meds less likely to fire up their inner furnace. Feel free to ask me for better alternatives to try first!
Opioid Pain Relievers: A Sweaty Side Effect
If you’re taking prescription opioid medications like codeine, morphine, oxycodone or hydrocodone to manage severe pain, you might sweat more than agony. Research indicates opioids potentially double or even quadruple hot flash frequency and severity due to interacting with temperature regulation pathways.[3] Ugh!
While clearly effective for short-term pain control after injuries or surgery, the tendency for opioids to dramatically worsen hot flashes gives me pause about casual ongoing use for chronic pain. And given risks like addiction and overdose, I steer midlife women toward safer alternatives like acetaminophen, topical NSAIDs, medical marijuana, acupuncture, PT, massage and dietary approaches first when possible.
But if you MUST continue opioids to function, work closely with your prescribing doctor to take the lowest effective doses. Avoid triggers that worsen hot flashes like warm rooms, spicy foods and alcohol which could stack more heat on top of med effects. And let me know if you need help managing withdrawal when ready to quit!
Blood Pressure & Heart Meds Causing Firestorms
If you popped a beta blocker like the blood pressure medications Tenormin or Inderal today, no wonder you feel hot and bothered! Studies confirm beta blockers reduce necessary compensatory dilation of blood vessels triggered when we overheat. [4] Translation: no vessel widening = no cooling off = sweltering hot flash city!
Making matters worse, beta blockers also disrupt nerve signaling pathways involved in sweating and temperature regulation — further sabotaging your body’s efforts to chill itself out. No wonder upto 18% of midlife women report hotter, longer and more frequent hot flashes taking them![5]
While clearly indicated for life-threatening heart conditions, I discourage casual beta blocker use for milder BP management in symptomatic menopausal women given quality of life impacts. If you must continue but find side effects unbearable, ask your doctor about modifying dose timing to avoid peak hot flash periods. Or consider trialing gentler alternative BP treatments like diuretics, calcium channel blockers or renin inhibitors less prone to heat deregulation first.
Cold & Allergy Meds: Nothing to Sneeze At!
If you reach for antihistamines like Claritin or Allegra to knock out allergy symptoms or decongestants like Sudafed to clear sinus congestion, they might unintentionally turn up your internal temperature gauge along with drying up drainage!
Researchers propose antihistamines impair sweating responses and vascular reactivity necessary for heat loss. [6] Meanwhile, decongestants constrict vessels needed to open wide for flushing heat away from your skin. No wonder multiple studies connect routine antihistamine and decongestant use to worse hot flash frequency/severity in menopausal women![7]
While definitely helpful for occasional allergy or cold relief, I suggest avoiding chronic daily antihistamine and decongestant use since quality of life impacts stack up over time. Instead, try nasal saline washes, nasal strips, hydration, steam, honey, eucalyptus rubs and air purification methods first to clear congestion allergies or colds without drug effects making your days hotter.
The Takeaway: Stop Suffering & Start Feeling More You
If bothersome hot flashes and night sweats have you singing sweaty summer songs on endless loop, check your medications! Numerous drug classes like SSRIs, opioids, beta blockers, antihistamines and decongestants frequently fan the flames of menopausal heat waves.
Before blaming your body, explore safer alternatives easing side effects so you can feel more like your old cool self. And let your care team know what DOES help you thrive in your midlife body with womanly wisdom intact! Here’s to relief from the inside out. ;-)
Stay cool out there sister,
Professor Peri
"I lovingly care for my body and spirit during this transitional time. Each day brings renewed comfort, empowerment, and inner peace.
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