Spray on HRT for Hot Flashes

If you’re suffering from moderate to severe menopausal hot flashes you may want to ask your doctor about an estrogen spray that is applied once daily to your forearm. It’s called Evamist and it was approved by the FDA last summer and reported in the June 2008 issue of Obstetrics & Gynecology. You can read a summary of the article here. It’s made from 17-Beta estradiol, a compound made from plants to be similar to the estrogen hormone that we produce from puberty to menopause and is involved in over 400 functions of the female body. (See my March 11th blogpost for an explanation on the three types of Estrogen). The metered spray delivers low-doses through the skin, thus bypassing the liver.

However, despite the convenience of a spray, this is still hormone replacement regardless of how it’s delivered. So consider and discuss these “red flags” with your physician.

• According to information I read on medilexicon, FDA approval of Evamist was based on the results of one, 12-week clinical trial of 454 postmenopausal women. It did show a “statistically significant and clinically significant” reduction in hot flush frequency,” but I personally wouldn’t bet my life on one short-term study with such a small sample size.

• According to Evamist prescribing and “black box” information “an increased risk of stroke, deep vein thrombosis, pulmonary embolism myocardial inforction and probably dementia has been reported with the use of estrogens with or without progestin.”

• An increased risk of invasive breast cancer has been reported with the use of estrogens plus progestins.

I know several women who suffer from debilitating hot flushes, so for them the benefits of taking hormones may out weigh the risks. It’s a personal decision that should be made with a doctor who will take the time to review all options with you.