Venlafaxine for hot flushes - WITH HRT

[Imalongtimepostingmum]

Hi all,

I have been on 100mcg oestrogen plus mirena plus testosterone for over 12months. I am still getting hot flushes and temperature disregulation. Some nights I'm still waking up with a soaking wet chest and my vest top needing to be changed.

My gynae suggested 37.5mg of venlafaxine to augment my current HRT.

Has anyone had success with anything else to help hot flushes where HRT isn't working?

For info, I barely drink (because if I do, hot sweat at night plus no sleep), diet is exceptionally good, exercise also very good indeed. Plus magnesium glyc 300mg elemental each night and the usual vitamins incl high vitamin D and B12.

Ferritin is in the 70s so not deficient.

I have had a very stressful few months, so possible that the stress is feeding it.

Any suggestions most welcome!

To add - I'm not convinced I want to start taking anti depressants but I'm getting desperate.

Oh, plus my oestrogen level is in the 600's so not too low and I don't want to change to gel.

It appears that a reduction in hot flashes is a secondary side effect and Venlafaxine is prescribed off label at doses of 75 to 150 mg.

I had it prescribed for depression and anxiety. It is very effective for that, but it did make me sweat. The initial side effects are rough. You also need to be very diligent about taking it at the same time each day, it has a short half life in the body and you can feel unwell quite quickly. Withdrawal is also difficult and long.

I can't say it did anything for my hot flushes. I can recommend for extreme paralysing anxiety, but you need to be aware of the downsides. I've been off it now for over three years, I still overheat, but the sweats have stopped.

Venlafaxine is a pretty heavy drug - lots of nasty side effects - made me a bit of a unwell zombie and gave me weird brain zaps. and had very serious withdrawal when trying to come off it - I really shook and felt like a drug addict. I feel there must surely be something better for you out there!

Having had venlafaxine and hot flushes, I would take the hot flushes any day.

Is it worth considering you may be exercising too much? Just a thought .

Do you need to do something that is more of a wind-down? Yoga? Headspace app? Mindfulness? Stress certainly feeds hot flushes, no doubt.

FWIW I have had several conversations with my gynae on testing estrogen and they are adamant it's not worth it (this is privately so it's not an NHS cost-saving thing.) I was told that for an accurate estrogen reading, blood needs taking for 24 hours a day (because of fluctuations.) So your readings may not be accurate. It also sounds very high. The level for effective osteoporosis treatment is above 250.

I think it all depends on how much the sweats are happening. I use 2 pumps of gel and I still have occasional nights when I do wake up with a sweaty chest and there's no reason for this- maybe happens a few times every 4 weeks or so.

I suffer these symptoms and I wouldn't touch venlafaxine with a barge pole. It's a really nasty med side effects wise, and if you ever have to come off it, it will be horrendous.

I take 75mg venlafaxine for anxiety and depression and it works really well. However, the only time I tried to come off it was horrendous, and my understanding is that it's not generally recommended any more for people who haven't already been taking it. It does have night sweats as a side effect as well.

Thanks all. This was my instinct. I wonder if there is anything else possibly supplement or plant based that works?

The gynae wrote the prescription in May and I've been deliberating ever since.

I probably have two or more nights a week where there is a relentless rolling of sweats - and when I've woken up and trying to sleep again, I feel the flushes rolling up my body.

@JinglingSpringbells I actually had six weeks off exercise completely (All I could do was slow walking) following surgery in the summer and I still had the night sweats. My exercises of choice are walking, swimming and yoga (vinyasa and yin), plus I meditate most days. (guided meditation on an app).

I will stay away from the venlafaxine on the basis of all your helpful posts, thank you.

If anyone can suggest anything better I would be very grateful!

You could try black cohosh which has some success with flushes etc.
It isn't supposed to be used very long term as in some doses it can cause liver issues.

If you want to dig around a bit into the research, the British Menopause Society has a report on 'alternatives to HRT' where they evaluate supplements etc. Basically, none are very effective but some show some improvement in some women.

thebms.org.uk/wp-content/uploads/2024/09/04-BMS-ConsensusStatement-Non-hormonal-based-treatments-SEPT2024-A.pdf

That's awesome, thanks @JinglingSpringbells