Q: What can I do to minimize hot flashes post-breast cancer?

You say that after a breast cancer diagnosis and treatment, your oncologist prescribed Anastrozole, which brings on hot flashes again, more frequent, longer, and more intense than ever.

I’m sorry, first, to hear of your breast cancer diagnosis. Those treatments often trigger bothersome menopausal symptoms. There isn’t great data supporting supplements for the treatment of hot flashes, but there are a few that have offered some patients a measure of relief: Magnesium 400 mg at bedtime (may make stools more loose and frequent), and Femarelle and Relizen (both available only online). 

Probably the most common non-hormonal medication used to treat hot flashes is venlafaxine (effexor), an antidepressant that happens to have the benefit of reducing hot flashes for some women (about 50 percent have about a 50 percent reduction in hot flashes). Start at 37.5 mg, and if that hasn’t helped in two weeks, go to 75 mg. If that dose doesn’t work, the medication won’t work; don’t go to higher doses. There are other antidepressants that can be of benefit, too, a conversation with your provider could help in the selection process.

Oxybutynin ER 15 mg, an overactive bladder medication, can be helpful in reducing hot flashes in some women (a side effect can be dry mouth). Neurontin (gabapentin) can reduce hot flashes, as well; start at 300 mg three times a day. This can be sedating, so some women do best with this as a bedtime solution only, not during waking hours.

I wish you well in your treatment and finding a solution for the hot flashes, too.