Hot flashes are among the most severe and frequent menopausal symptom experienced by postmenopausal women and breast cancer survivors. In fact, over 66% of healthy menopausal women and 78% of women treated for breast cancer experience hot flashes. Kronenberg et al. described a hot flash as “a transient episode of flushing, sweating, and a sensation of heat, often accompanied by palpitations and a feeling of anxiety, and sometimes followed by chills.” The onset of a hot flash is sometimes preceded by an aura, but it often manifests itself suddenly. The initial symptoms typically included a rise in heart rate and peripheral blood flow. The sensation of a wave of heat spreads over a person’s body, especially the upper body, causing him or her to sweat. Although there is a sensation of heat, evaporation of sweat from the forehead and chest results in a drop in temperature in these areas. As a result, the flash is sometimes followed by a chilled feeling.
Several studies have identified hot flashes as the most frequently reported physiological and psychological experiences associated with menopause. Hot flashes can be severe and interfere with daily activities. For example, in a study examining the symptoms associated with hot flashes among breast cancer survivors, 89 of 102 women reported having severe hot flashes. Some physical symptoms included weakness, feeling faint, rapid heartbeat, and itching sensations. Over one third (37%) noted that the hot flashes interfered with their routines and disrupted their sleep. Thirty-seven percent of the women indicated that these hot flashes interfered with their daily activities and disrupted sleep. Pansini et al. reported similar symptom presentation of hot flashes and also identified headaches, irritability, palpitations, and vertigo as common symptoms.
Keywords
- Breast Cancer Survivor
- Mental Imagery
- Menopausal Symptom
- Black Cohosh
- Community Clinical Oncology Program
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Kronenberg F, Cote LJ, Linkie DM, Dyrenfurth I, Downey JA. Menopausal hot flashes: thermoregulatory, cardiovascular, and circulating catecholamine and LH changes. Maturitas. 1984: 6;31–43.
Ginsberg J, Swinhoe J, O’Reilly B. Cardiovascular responses during the menopausal hot flush. Br J Obstet Gynaecol. 1981; 88:925–930.
Kronenberg F, Downey JA. Thermoregulatory physiology of menopausal hot flashes: a review. Can J Physiol Pharmacol. 1987; 65:1312–1324.
Tataryn IV, Lomax P, Bajorek JG, Chesarek W, Meldrum DR, Judd HL. Postmenopausal hot flushes: a disorder of thermoregulation. Maturitas. 1980; 2:101–107.
Finck G, Barton D L, Loprinzi CL, Quella SK, Sloan JA. Definitions of hot flashes in breast cancer survivors. J Pain Symptom Manage. 1998; 16:327–333.
Pansini F, Albertazzi P, Bonaccorsi G, et al. The menopausal transition: a dynamic approach to the pathogenesis of neurovegetative complaints. Eur J Obstetr Gynecol Reprod Biol. 1994; 57:103–109.
Keenan NL, Mark S, Fugh-Berman A, Browne D, Kaczmarczyk J, Hunter C. Severity of menopausal symptoms and use of both conventional and complementary/alternative therapies. Menopause. 2003;10;507–515.
Anderson GL, Limacher M, Assaf AR, Bassford T, Beresford SA, Black H, Bonds D, Brunner R, Brzyski R, Caan B, Chlebowski R, Curb D, Gass M, Hays J, Heiss G, Hendrix S, Howard BV, Hsia J, Hubbell A, Jackson R, Johnson KC, Judd H, Kotchen JM, Kuller L, LaCroix AZ, Lane D, Langer RD, Lasser N, Lewis CE, Manson J, Margolis K, Ockene J, O’Sullivan MJ, Phillips L, Prentice RL, Ritenbaugh C, Robbins J, Rossouw JE, Sarto G, Stefanick ML, Van Horn L, Wactawski-Wende J, Wallace R, Wassertheil-Smoller S; Women’s Health Initiative Steering Committee (2004). Effects of conjugated equine estrogen in postmenopausal women with hysterectomy: the Women’s Health Initiative randomized controlled trial. Journal of the American Medical Association, 291, 1701–1712.
Quella SK, Loprinzi CL, Barton JA, et al. Evaluation of soy phytoestrogens for the treatment of hot flashes in breast cancer survivors: a north central cancer treatment group trial. J Clin Oncol. 2000; 18(5):1068–1074.
Barton DL, Loprinzi CL, Quella SK, et al. Prospective evaluation of vitamin E for hot flashes in breast cancer survivors. J Clin Oncol. 1998; 16:495–500.
Pandya KJ, Morrow GR, Roscoe JA, et al. Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial. Lancet. 2005; 366(9488):818–824.
Uebelhack R, Blohmer JU, Graubaum HJ, Busch R, Gruenwald J, Wernecke KD. Black cohosh and St. John’s wort for climacteric complaints: a randomized trial. Obstet Gynecol. 2006; 107(2 Pt I):247–255.
Loprinzi CL, Goldberg RM, O’Fallon JR, et al. Transdermal clonidine for ameliorating post-orchiectomy hot flashes. J Urol. 1994; 151(3):634–636.
Pandya KJ, Raubertas RF, Flynn PJ, et al. Oral clonidine in postmenopausal patients with breast cancer experiencing tamoxifen-induced hot flashes: a University of Rochester Cancer Center Community Clinical Oncology Program study. Ann Intern Med. 2000; 132(10):788–793.
Goldberg RM, Loprinzi CL, O’Fallon JR, et al. Transdermal clonidine for ameliorating tamoxifen-induced hot flashes. J Clin Oncol. 1996; 12(1):155–158.
Nelson HD, Vesco KK, Haney E, et al. Nonhormonal therapies for menopausal hot flashes. JAMA. 2006;295:2057–2071.
Stearns V, Isaccs C, Rowland J, et al. A pilot trial assessing the efficacy of paroxetine hydrochloride (Paxil) in controlling hot flashes in breast cancer survivors. Ann Oncol. 2000; 1(1):17–22.
Loprinzi CL, Kugler JW, Sloan JA, et al. Venlafaxine in management of hot flashes in survivors of breast cancer: a randomised controlled trial. Lancet. 2000; 356(9247):1486–1490.
Loprinzi CL, Sloan JA, Perez PA, et al. Phase III evaluation of flouxetine for treatment of hot flashes. J Clin Oncol. 2002; 20(1):578–583.
Stearns V, Beebe KL, Lyengar M, Dube E. Paroxetine controlled release in the treatment of menopausal hot flashes: a randomized controlled trial. JAMA. 2003; 289:2827–2834.
Barton DL, Loprinzi CL, Novotny P, et al. Pilot evaluation of citalopram for the relief of hot flashes. J Support Oncol. 2003; 1(1):47–51.
Perez DG, Loprinzi CL, Barton DL, et al. Pilot evaluation of mirtazapine for the treatment of hot flashes. J Support Oncol. 2004; 2(1):50–56.
Loprinzi CL, Pisansky TM, Fonseca R, et al. Pilot evaluation of venlafaxine hydrochloride for the therapy of hot flashes in cancer survivors. J Clin Oncol. 1998; 16(7):2377–2381.
Elkins G, Marcus J, Palamara L, Stearns V. Can hypnosis reduce hot flashes in breast cancer survivors? A literature review. Am J Clin Hypn. 2004; 47(1):29–42.
Elkins G, Marcus J, Stearns V, Rajab HM. Pilot evaluation of hypnosis for the treatment of hot flashes. Psychooncology. 2006; 16:487–492.
Kronenberg F. Hot flashes: phenomenology, quality of life, and search for treatment options. Exp Gerontol. 1994; 29(3/4):319–336.
Voda AM. Climacteric hot flash. Maturitas. 1981; 3:73–90.
Gannon L, Hansel S, Goodwin J. Correlates of menopausal hot flashes. J Behav Med. 1987; 10:277–285.
Kronenberg F. Hot flashes: epidemiology and physiology. Ann N Y Acad Sci. 1990; 592: 52–86.
Stevenson DW, Delprato D. Multiple component self-control program for menopausal hot flashes. Journal of Behavior Therapy and Experimental Psychiatry. 1983; 14:137–140.
Irvin J.H, Domar AD, Clark C, Zuttermeister PC, Friedman R. The effects of relaxation response training on menopausal symptoms. J Psychosom Obstetr Gyneaecol. 1996; 17:202–207.
Wijma AG, Melin A, Nedstrand E, Hammar M. Treatment of menopausal symptoms with applied relaxation: a pilot study. J Behav Ther Exp Psychiatry. 1997; 28:251–261.
Freedman RR, Woodward S. Behavioral treatment of menopausal hot flushes: evaluation by ambulatory monitoring. Am J Obstet Gynecol. 1992; 167:436–439.
Keefer L, Blanchard EB. A behavioral group treatment program for menopausal hot flashes: results of a pilot study. Appl Psychophysiol Biofeedback. 2005; 30(1):21–30.
Araoz DL. Use of hypnotic techniques with oncology patients. J Psychosoc Oncol. 1893; 1(4):47–54.
Burish TG, Snyder SL, Jenkins RA. Preparing patients for cancer chemotherapy: Effect of coping preparation and relaxation interventions. J Consult Clin Psychol. 1991; 59:518–525.
Decker T, Cline-Elsen J, Gallagher M. Relaxation therapy as an adjunct in radiation oncology. J Clinl Psychol. 1992; 48:388–393.
Gruber BL, Hersh SP, Hall NRS, et al. Immunological responses of breast cancer patients to behavioral interventions. Biofeedback Self Regul. 1993; 18(1):1–21.
Younus J, Simpson I, Collins A, Wang X. Mind control of menopause. Women’s Health Issues. 2003; 13(2):74–78.
Hammond DC, Elkins GR. Standards of Training in Clinical Hypnosis. Chicago: ASCH Press; 1994.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Elkins, G.R., Ruud, C., Perfect, M. (2008). Biobehavioral Management of Hot Flashes in a 48-Year-Old Breast Cancer Survivor. In: Kessler, R., Stafford, D. (eds) Collaborative Medicine Case Studies. Springer, New York, NY. https://doi.org/10.1007/978-0-387-76894-6_16
Download citation
DOI: https://doi.org/10.1007/978-0-387-76894-6_16
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-76893-9
Online ISBN: 978-0-387-76894-6
eBook Packages: Behavioral ScienceBehavioral Science and Psychology (R0)