Wednesday, 27 May 2009

Nerve injection that can stop the nightmare of hot flushes

An injection in the neck might ease the symptoms of hot flushes. It blocks nerve signals involved in temperature regulation, and early results show that it can be highly successful.
In one study, the number of hot flushes women experienced in a week was cut by 90 per cent after a single injection. The women also had a similar reduction in night awakenings, a consequence of hot flushes.
Hot flushes are a common symptom of the menopause, affecting around 80 per cent of women.

They are a sudden sensation of intense heat or sweating in the upper body, which can start in the face, neck or chest before spreading upwards or downwards. They tend to last for five to ten minutes - and typically persist for two to three years.
Flushes occur when there is an increase in the amount of blood flowing to the skin. This causes a rise in skin temperature and leads to blood vessels just under the skin surface dilating, giving the characteristic florid cheeks associated with the menopause.
The exact cause of hot flushes is unknown. One theory is that the drop in levels of oestrogen that occurs around the menopause affects the hypothalamus, the part of the brain involved in the control of body temperature. Another theory is that changes in other brain chemicals, including serotonin, may be involved.

While for some women these symptoms are simply a nuisance, for others, the flushes and sweating can be very distressing, affecting many aspects of life, including work and sleep.
Some women find that hot flushes can be triggered by stress, alcohol, caffeine or spicy foods, so simply cutting back may help.
There is also a wide range of treatments available including HRT. This works by increasing levels of oestrogen, but it has been linked to side-effects such as bloating, weight gain, headaches and, more seriously, an increased risk of breast cancer.

Antidepressants, which increase levels of serotonin, are another treatment option, though again there is a risk of side-effects.
The new treatment is known as a stellate ganglion nerve block. The stellate ganglion is a collection of nerves on either side of the neck. It is part of the sympathetic nervous system which helps regulate heart rate, blood pressure and breathing rate. It also causes blood vessels to narrow, and is involved in sweating and temperature regulation.
'Some women find hot flushes can be triggered by stress, alcohol, caffeine or spicy foods, so simply cutting back may help'

It's thought that blocking the action of these nerves prevents the rise in skin temperature.
In a new trial at the Mayo Clinic in America, the treatment is being given to women who have had hot flushes for more than a month (with more than 28 a week) and found antidepressants and other treatments ineffective.
During the treatment, which takes around five minutes, a local anaesthetic is injected into the nerves with the help of X-ray guidance.
Patients are then being asked to keep a hot-flush and symptom diary for seven weeks. They will be followed up at two months, and thereafter monthly for a year.
Earlier smaller studies have already shown the injection to be highly effective. In one study at the University of Illinois, all 15 women who had the nerve block treatment had a minimum of an 80 per cent relief of symptoms, with few or no side-effects.

In a second study at the same centre, the frequency of hot flushes and sleep disturbance in women with breast cancer decreased by about 90 per cent after 12 weeks. How long the treatment is effective varied between patients: it is thought that some patients might need more injections to provide a longer-term effect.
'This is an interesting preliminary study,' says Sanjay Vyas, consultant gynaecologist at Southmead Hospital in Bristol. 'Hot flushes affect millions of women, and HRT, which is effective, does carry some risk. Anything that provides relief from hot flushes but does not carry risk would be welcome.
'I look forward to the results of larger studies, which should identify the risks and side-effects, as well as the benefits.'


  1. Ha - I love the pic of the lady with the bucket of water! I have been lucky with my hot flashes - they tend to be more like "warm" flashes and I don't get too many. But some of my friends suffer horribly from them. I was worried to start with - some people told me that when menopause is medically induced, the symptoms are far worse. That hasn't been the case for me. I feel very lessed.

    I love when you post informational stuff like this Tracey!

  2. amazing!! I want that injection immediately! I will keep as many diaries as they like! I'm pretty lucky as I don't suffer too badly, but they affect my sleep a lot...a full night's sleep would be rather nice.

    Going to print this off and give it to my onc and see if we can have it here.

    Thanks mate! :o)

  3. Oh, my good golly! I want that shot. Hot flashes have been a shock for me. Menopause started with chemo. It wasn't quite so awful in the winter, but now in the summer, I find myself speaking with someone, and a hot flash begins. By the time it is over, I have sweat on my upper lip, sometimes running off the back of my neck. I lose track of what I am saying, and am always surprised that the other person cannot tell what is going on just by looking at me. I feel as if I should be beet red and glowing. Once having a wonderful meal out with friends, I actually had to leave the restaurant. Some nights I wake up repeatedly through the night. They seem to be getting worse and I have been told it is the tamoxifen, which I've been taking for a month. I've been given effexor to control them, but it doesn't seem to work.

  4. Wow!!!!!! I gotta have that shot!!!!! I'm on Arimidex, and the night sweats are just awful! I'm sleeping with ice packs. I'm going to ask about this shot, believe you me!

  5. Tracey, Great bog! great photos! I have added you to my blogroll, Cancer Blog Links at in both the ovarian and cervical sections - tough break, that!
    Take care, Dennis