In a groundbreaking study, scientists have discovered a method to alleviate hot flashes through a single injection of a nerve-blocking agent. This study, the first randomized, controlled investigation of its kind, unveiled the positive effects of the injection and was published online in the journal Menopause, associated with the North American Menopause Society. Recent research has validated the effectiveness of using a nerve-blocking agent in the neck to significantly reduce severe hot flashes, a troublesome symptom during menopause.
Hot flashes, characterized by sudden sensations of overwhelming heat, racing heartbeats, and uncontrollable sweating, can be particularly distressing for women navigating the challenges of menopause.
The injection targets a cluster of nerves in the neck known as the stellate ganglion. Dr. Pauline Maki, a professor of psychiatry and psychology at the University of Illinois at Chicago and the study’s senior author, explained that the idea to explore the potential of stellate ganglion block in reducing hot flashes stemmed from clinical observations made by anesthesiologists. They initially used this anesthesia procedure for pain management, and patients reported a sudden reduction in the severity of their hot flashes. These observations piqued the interest of researchers, leading to this groundbreaking investigation.
In Dr. Maki’s research, women experiencing natural menopause were administered an anesthetic injection into the stellate ganglion. These women maintained symptom journals and wore skin monitors to gauge the intensity of their hot flashes. Half of the participants were given a placebo saline solution injection and tracked their symptoms.
Initially, both groups experienced an improvement in their hot flashes. Women who received the nerve block witnessed a reduction in hot flash intensity of over 50 percent. Meanwhile, those who received the placebo injection still experienced an improvement exceeding 30 percent, underscoring the influence of the mind.
However, after three months post-injection, the placebo effect subsided, whereas the effects of the nerve block persisted robustly. Dr. Maki remarked, “It did not appear to be waning, indicating potential nervous system remodeling. Although the mechanism of action remains unclear, it exhibits a sustained impact over time.”
Furthermore, the effectiveness of the stellate ganglion block correlated with the severity of hot flashes. Those with mild to moderate hot flashes saw limited relief, whereas individuals grappling with moderate to severe hot flashes experienced substantial benefits. Symptoms of hot flashes encompass clammy skin, dry mouth, muscle tension, anxiety, restlessness, dizziness, headaches, and sensations of warmth.
This investigation isn’t the inaugural exploration of this phenomenon. Prior uncontrolled studies involving menopausal breast cancer survivors revealed that a stellate ganglion block could diminish hot flashes by 50 to 90 percent, with effects lasting up to a year. Nevertheless, this particular study stands out as the first to implement rigorous scientific controls, a step toward potentially introducing the treatment to the market.
But why opt for a stellate ganglion block to alleviate hot flashes? It’s essential to recognize that it doesn’t match the efficacy of hormone replacement therapy.
Dr. Maki explains, “It’s not a straightforward answer. Hormone therapy, specifically estrogen, remains the gold standard for hot flash treatment. Nothing surpasses estrogen in reducing hot flashes, with efficacy reaching 90 to 95 percent.” Menopause entails the body ceasing its natural production of estrogen and other reproductive hormones, and supplementing with hormones can significantly alleviate the transition for many women.
However, relying on hormones doesn’t offer a flawless solution. “Many women are reluctant to take hormones due to concerns about potential health risks,” as explained by Dr. Maki. “Additionally, some women avoid estrogen because of a family history of breast cancer or other risk factors associated with adverse effects linked to hormone therapy. This is where the stellate ganglion blockade steps in.”
The Food and Drug Administration (FDA) has approved alternative medications for addressing hot flashes, such as gabapentin and SSRI antidepressants. Nevertheless, these options necessitate daily pill consumption and may entail several side effects. In contrast, the stellate ganglion block requires only a single administration and is associated with no known long-term side effects.
While Dr. Maki’s study focused on women experiencing natural menopause with age, her ultimate objective is to investigate breast cancer patients. Their ovaries can be impacted by chemotherapy, radiation, or surgical removal. In cases where their ovaries survive the treatment, breast cancer patients often transition to medications that halt estrogen production in their bodies, as estrogen can trigger cancer recurrence.
Regardless of the approach, these treatments swiftly and permanently propel their bodies into full menopause, a more abrupt and challenging transition compared to the gradual process experienced by middle-aged women over time.
“It’s regrettable because there is some evidence suggesting that entering menopause at an early stage in life is linked to various unfavorable health outcomes,” noted Dr. Maki. “Moreover, women dealing with breast cancer often experience particularly severe and frequent hot flashes, and they are unable to pursue the gold standard treatment for hot flashes, which is estrogen.”
While the stellate ganglion block may not address the entirety of menopausal symptoms, it holds the potential to provide genuine relief for breast cancer survivors contending with hot flashes. “They no longer need to rely on a daily medication; instead, they can opt for a single procedure,” explained Maki. “This represents the next phase of our research.”