How can I treat hot flashes when I have breast cancer?

Hot flashes can be a real challenge to good quality of life in the perimenopausal woman who has breast cancer or is a breast cancer survivor. Estrogen use in the form of a pill or spray or patch that supplies estrogen to the whole body is not recommended.

The only medicinal substitute shown to be as effective at treating hot flashes as estrogen is gabapentin, brand name Neurontin. The typical dose is 300mg taken three times a day. Gabapentin does have its own set of side effects such as fatigue, dizziness, swelling in the hands and feet, headache, and nausea, among others. Starting at a low dose and gradually increasing the dose to the effective or recommended level helps reduce or eliminate the side effects.

Many forms of drugs typically used to treat depression have been studied. In general, these drugs were minimally effective, lowering the number of hot flashes by one episode per day.

Soy protein, and its active ingredient called isoflavone, has been effective at reducing hot flashes in some studies while not in others. The amount generally recommended is 50 grams or about 2 ounces of soy daily.