A study from JAMA suggested that more than half of women who started taking hormone replacement therapy (HRT) to relieve symptoms of menopause saw a dramatic resurgence of those symptoms when they discontinued the therapy.

With the evidence showing that HRT is harmful and can increase mortality, more physicians are counseling women to come off these medications. Unfortunately, hormones continue to be one of the most effective treatment for hot flashes.

So, what are the alternative medications? There are some studies suggesting that a clonidine patch, put on once per week can help.

Antidepressants, such as Effexor and the SSRIs have also been shown to be helpful. effexor is the medication with the most data backing it.

Finally, some progestin administration has also been shown to help. Megace is the medication most frequently used.

There are some where nothing else works except estrogen. In these cases, discussion should be made with one's personal physician, as there are patients who are willing to take the increased risk of cancer and heart disease in exchange for relief of menopausal hot flashes. (Ockene et. al, "Symptom Experience After Discontinuing Use of Estrogen Plus Progestin", JAMA, Jul.13)