Cases reported "Hot Flashes"

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1/20. Progressive prostate cancer associated with use of megestrol acetate administered for control of hot flashes.

    Low doses of megestrol acetate are frequently used for treatment of hot flashes in men having androgen ablation for prostate cancer. We report a case in which megestrol acetate (20 mg bid) was administered for symptomatic control of hot flashes in a medically castrated patient with prostate cancer. The patient was subsequently noted to have a rising prostate-specific antigen (PSA) level. megestrol acetate administration was discontinued, and the PSA level declined. These data indicate that even the low doses of megestrol acetate used for control of hot flashes can be associated with PSA increases in some patients with prostate cancer. ( info)

2/20. Prescribing hormone replacement therapy for menopausal symptoms.

    This paper addresses the clinical presentation of menopause, pretreatment assessment for hormone replacement therapy, benefits and risks of this treatment, common hormone replacement regimens and their side effects, and patient management. The case-based discussion focuses on the clinical management of a patient who is considering hormone replacement therapy for menopausal symptoms. ( info)

3/20. Gabapentin's effects on hot flashes and hypothermia.

    The author describes six cases in which gabapentin treatment reduced the frequency of hot flashes. In addition, gabapentin treatment enhanced the frequency of hypothermic episodes in a separate patient with known hypothalamic dysfunction. Gabapentin may act directly upon temperature regulatory centers. ( info)

4/20. Treatment of hot flushes with mirtazapine: four case reports.

    OBJECTIVE: To evaluate the effect of mirtazapine on the severity of hot flushes and bouts of perspiration in women. Method: In two women with depression a reduction in hot flushes was noticed by serendipity during treatment with mirtazapine 15-30 mg/daily. On the basis of this observation clinical studies were extended with two non-depressed and non-anxious women with hot flushes. Both subjects were prescribed mirtazapine daily. RESULTS: Four cases are described as case reports. All subjects reported a practically complete disappearance of hot flushes and associated perspiration, within the first week of treatment. CONCLUSION: Mirtazapine appears to have a substantial ameliorating effect on hot flushes and perspiration bouts. It is postulated that the 5-HT(2A) blocking properties of mirtazapine is accounted in the symptomatic relief of hot flushes. In addition it is hypothesized that the serotonergic system is crucially involved in the pathogenesis of hot flushes and perspiration bouts. Further evaluation in double-blind placebo-controlled studies is encouraged. ( info)

5/20. Transient ovarian failure: a complication of uterine artery embolization.

    OBJECTIVE: To report a case of transient ovarian failure shortly after arterial embolization for treatment of uterine fibroids, followed by recovery of ovarian function. DESIGN: Case report. SETTING: A university-based hospital. PATIENT: A 49-year-old woman with menorrhagia and anemia secondary to uterine fibroids and refractory to medical management. The follicle-stimulating hormone (FSH) level on cycle day 3 before the procedure was 8.2 mIU/mL. INTERVENTION(S): Bilateral uterine artery embolization for treatment of menorrhagia. MAIN OUTCOME MEASURE(S): serum FSH level. RESULT(S): The patient developed amenorrhea and hot flashes 3 months after uterine artery embolization. Her serum FSH level at that time was 140.1 mIU/mL. Four months later, uterine bleeding resumed; her serum FSH level was 2.1 mIU/mL. CONCLUSION(S): uterine artery embolization may hasten ovarian failure. This procedure should be reserved for women who have completed their child-bearing or are poor candidates for myomectomy. patients should be counseled appropriately about the risk of possible ovarian failure. ( info)

6/20. Gabapentin for hot flashes in prostate cancer.

    OBJECTIVE: To report a case of successful treatment of refractory hot flashes with gabapentin in a patient with prostate cancer who was receiving combination antiandrogen and gonadotropin hormone-releasing hormone (GnRH) analog therapy. CASE SUMMARY: A 70-year-old white man with a history of advancing prostate cancer experienced disabling hot flashes from combination therapy with the antiandrogen bicalutamide and the GnRH analog goserelin acetate. He failed to respond to clonidine 0.1 mg twice daily, megestrol acetate 40 mg/d, diethylstilbestrol 1 mg/d, and venlafaxine 25 mg twice daily. The patient was then treated with gabapentin 600 mg once daily, at which time he experienced near-complete resolution of his symptoms. DISCUSSION: This case supports a previous report of the marked improvement in severity and duration of hot flashes associated with antiandrogen or GnRH analog therapy in prostate cancer. The mechanism by which gabapentin reduces hot flashes is unknown. CONCLUSIONS: hot flashes resulting from antiandrogen or GnRH analog therapy are often difficult to treat and leave many patients disabled. Gabapentin has been shown to markedly reduce the severity, frequency, and duration of these hot flashes. Controlled trials are necessary to evaluate gabapentin against other therapeutic modalities. ( info)

7/20. trifolium pratense for breast disease: a case series.

    A series of cases in which trifolium pratense was used in breast disease with hyperoestrogenic symptoms is reported. Several patients with cystic mastosis and breast cancer appeared to do well. The 'picture' of trifolium is discussed. ( info)

8/20. hot flashes refractory to HRT and SSRI therapy but responsive to gabapentin therapy.

    There is a need for alternative therapies for hot flashes, as hormone replacement therapy (HRT) is associated with increased rates of breast cancer and heart disease, and some women fail to respond to HRT. A 32-year-old woman with surgically-induced menopause experienced 20-30 severe hot flashes per day and failed to respond to various formulations of HRT and selective serotonin reuptake inhibitor (SSRI) therapy for 17 years. She markedly responded to gabapentin therapy. Gabapentin, SSRIs, and estrogen may act at different cellular targets in the treatment of hot flashes. ( info)

9/20. Anticonvulsant hypersensitivity syndrome associated with Bellamine S, a therapy for menopausal symptoms.

    Anticonvulsant hypersensitivity syndrome (AHS) is a rare, potentially fatal, idiosyncratic drug reaction characterized by fever, morbilliform rash, lymphadenopathy, hepatitis, and hematologic abnormalities. Aromatic antiepileptic agents, such as phenytoin, carbamazepine, and phenobarbital are the most frequent causes of this syndrome. We report a case of a previously healthy, postmenopausal woman who developed anticonvulsant hypersensitivity syndrome while taking Bellamine S (belladonna alkaloids; ergotamine; phenobarbital) for hot flashes. Although combinations of belladonna, ergotamine, and phenobarbital have been used for medical treatment of menopausal symptoms since the 1960s, this is the first known case report of its association with anticonvulsant hypersensitivity syndrome. Given the current debate about the risks of hormonal replacement therapy, more women are seeking alternative therapies for menopausal symptoms. Dermatologists need to be aware of this potential serious reaction to this phenobarbital-containing therapy for hot flashes. ( info)

10/20. Autoimmune hepatitis associated with the use of black cohosh: a case study.

    Herbal remedies generate more than 1.8 billion dollars in annual sales in the united states. Herbal products have been associated with a wide spectrum of hepatic toxicities. With the recent women's health Initiative Study demonstrating increased risk of breast cancer and cardiovascular events associated with hormone therapy, many women may resort to herbal remedies for persistent menopause symptoms. We report a case of autoimmune hepatitis likely triggered by the use of black cohosh (actaea racemosa), an agent marketed to treat menopause symptoms. Given this case report, we recommend close monitoring of women using this herbal preparation. ( info)
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