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Menopause Therapy Center If you are a woman over 35 years old bothered by hot flashes, night sweats, or sleeping problems and interested in finding relief without taking hormones, the Menopause Therapy Center is the place for you. Call 716-932-6080, option 3 to make an appointment. Dr. Thomas Guttuso, Jr., MD is the Director of the Menopause Therapy Center. Dr. Guttuso has been successfully treating women with these menopausal symptoms since 1998 using safe, non-hormonal medications that are truly effective. The Menopause Therapy Center practices what's known as "evidence-based medicine" for treating hot flashes and night sweats. This means that the only therapies that are prescribed are those that have demonstrated effectiveness in well-designed medical research studies. Hot Flashes & Night Sweats: Hot Flashes affect about 75% of women after going through menopause. For many women, hot flashes start years before they stop menstruating (stop having a menstrual period) but then get worse after they fully stop menstruating. Hot flashes are often triggered by stress, anxiety or drinking alcohol but most hot flashes occur without any precipitator. When a hot flash strikes, there's no mistaking it: a women suddenly feels extremely hot inside and often her face flushes and she perspires or sweats. The whole episode usually lasts 3-5 minutes before resolving. Often, a woman will then feel cold after the resolution of the hot flash. Hot flashes that occur at night are called night sweats and are very bothersome for women because of the associated insomnia. Women repetitively will throw the bed sheets off and then back on with each night sweat. Because of the associated insomnia, women with night sweats often feel sleepy during the day and experience impaired concentration and irritability of mood. Hot flashes are actually neurological symptoms that are caused by the low estrogen levels that naturally occur during menopause. The temperature regulatory center of the body is located in the brain and is very sensitive to estrogen levels. With each hot flash there are dramatic rises in the blood in chemicals that are secreted by the brain.¹ Treatments for Hot Flashes & Night Sweats: Hormone replacement therapy (HRT), made up of estrogen and progesterone medications, is currently the only treatment that has been approved by the US Food & Drug Administration (FDA) specifically for treating hot flashes. In 2002, a landmark study called the Women's Health Initiative showed HRT to be associated with higher rates of breast cancer, heart disease, and stroke.² Because of these significant risks, many women have decided not to take HRT for their menopausal symptoms. Unfortunately, this means that women are left to suffer with their hot flashes, night sweats, and sleeping problems. Women don't need to suffer. There are 2 safe, non-hormonal medications that have been shown in well-designed medical research studies to be effective for treating hot flashes and night sweats. They are gabapentin and oxybutynin. Gabapentin has been available since 1994 and is approved by the FDA for treating neuropathic pain, seizures, and restless legs syndrome. Dr. Guttuso discovered gabapentin to effectively reduce hot flashes by accident when treating a woman with gabapentin for her migraine headaches.³ Fascinated by this woman's relief, Dr. Guttuso performed the first well-designed research study that showed gabapentin indeed was effective for treating hot flashes.⁴ Other doctors have subsequently confirmed this exciting finding in 3 other studies.^5-7 CBS Evening News Video Clip In addition to being an effective treatment for hot flashes and night sweats, gabapentin has also has been shown to greatly improve sleep for women with hot flashes.⁸ The main side effects of gabapentin are sleepiness and dizziness. Oxybutynin has been available since 1997 and is FDA approved for treating urinary incontinence. There has only been 1 well-designed medical research study published showing oxybutynin to be an effective hot flash therapy.⁹ The main side effects of oxybutynin are dry mouth and constipation. Are gabapentin and oxybutynin experimental treatments? No. Gabapentin and oxybutynin are both FDA-approved medications that have been widely prescribed and have a proven safety record since at least 1997. Both medications have also been shown to be effective for treating hot flashes, although neither medication is currently FDA-approved specifically for treating hot flashes. Doctors frequently prescribe medications for "off-label use" (i.e. for a condition other than the FDA-approved indication) if there is sound evidence that the medication is safe and effective for this other condition. Gabapentin and oxybutynin certainly meet this standard. Their use for treating hot flashes is not experimental but is based on sound medical evidence and many years of proven safety. Do the All-Natural, Over-the-Counter Hot Flash Treatments Work? For most women with hot flashes, the over-the-counter hot flash therapies are ineffective. Some women may experience a few weeks or months of benefit from over-the-counter therapies like soy/isoflavones (eg, Estroven) or black cohosh (eg, Estroven and Remifemin); however, few experience significant, long-term relief from their hot flashes and night sweats. In general, the Menopause Therapy Center does not recommend the use of these over-the-counter hot flash treatments mostly because there is no good evidence that they are effective. It simply doesn't make sense to spend your money and time on false hope. About Dr. Guttuso: Dr. Guttuso received his bachelor's degree in 1988 in psychology from Cornell University, his master's degree in 1992 in psychology from the University at Buffalo and his medical degree (MD) in 1996 from the University at Buffalo. He performed his residency in neurology and fellowship in movement disorders at the University of Rochester. He joined the faculty in the department of neurology at the University at Buffalo in 2003. Dr. Guttuso is board-certified in Neurology. Dr. Guttuso has published his research in reputable journals including Lancet, Obstetrics & Gynecology, Menopause, and Neurology. Most of his research has been funded by the National Institutes of Health (NIH). His research has also been featured in Reader's Digest, Time Magazine, and on CBS Evening News with Dan Rather. Conclusion: If you are tired of being tired or fed up with being hot and sweaty, you deserve to learn the facts about how you can be helped safely, without the use of hormones. Call the Menopause Therapy Center in Williamsville, NY (a suburb of Buffalo, NY) for your personal consultation with Dr. Guttuso. Our offices are conveniently located at the Jacobs Neurological Institute at 300 Essjay Road, Suite 100. Call 716-932-6080, option 3 for an appointment Menopause Therapy Center Jacobs Neurological Institute 300 Essjay Road, Suite 100 Williamsville, NY 14221 716-932-6080. View Larger Map If you live too far from Buffalo, NY to make a visit to the Menopause Therapy Center, click here to access a document that Dr. Guttuso prepared specifically for patients to print and provide to their health care practitioner. This will provide all of the information needed for your practitioner to decide if he or she would like to prescribe one of these medications for you. References: 1. Genazzani AR, Petraglia F, Facchinetti F, Facchini V, Volpe A, Alessandrini G. Increase of proopiomelanocortin-related peptides during subjective menopausal flushes. Am J Obstet Gynecol 1984;149:775-9. 2. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. Jama 2002;288:321-33. 3. Guttuso TJ, Jr. Gabapentin's effects on hot flashes and hypothermia. Neurology 2000;54:2161-3. 4. Guttuso T, Jr., Kurlan R, McDermott MP, Kieburtz K. Gabapentin's effects on hot flashes in postmenopausal women: a randomized controlled trial. Obstet Gynecol 2003;101:337-45. 5. Butt DA, Lock M, Lewis JE, Ross S, Moineddin R. Gabapentin for the treatment of menopausal hot flashes: a randomized controlled trial. Menopause 2008;15:310-8. 6. Pandya KJ, Morrow GR, Roscoe JA, Zhao H, Hickok JT, Pajon E, et al. Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial. Lancet 2005;366:818-24. 7. Reddy SY, Warner H, Guttuso T, Jr., Messing S, Digrazio W, Thornburg L, et al. Gabapentin, Estrogen, and Placebo for Treating Hot Flushes: A Randomized Controlled Trial. Obstet Gynecol 2006;108:41-8. 8. Yurcheshen ME, Guttuso T, McDermott M, Holloway RG, Perlis M. Effects of Gabapentin on Sleep in Menopausal Women with Hot Flashes as Measured by a Pittsburgh Sleep Quality Index Factor Scoring Model. J Womens Health (Larchmt) 2009;18:1355-60. 9. Simon JA, LaGuardia KD. Extended-release oxybutynin relieves vasomotor symptoms in healthy postmenopausal women. Obstet Gynecol 2007;109:76S.	Links Treatment Centers Specialty Centers Location/Direction Administration Make a Donation
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Menopause Therapy Center

If you are a woman over 35 years old bothered by hot flashes, night sweats, or sleeping problems and interested in finding relief without taking hormones, the Menopause Therapy Center is the place for you. Call 716-932-6080, option 3 to make an appointment.

Dr. Thomas Guttuso, Jr., MD is the Director of the Menopause Therapy Center. Dr. Guttuso has been successfully treating women with these menopausal symptoms since 1998 using safe, non-hormonal medications that are truly effective.

The Menopause Therapy Center practices what's known as "evidence-based medicine" for treating hot flashes and night sweats. This means that the only therapies that are prescribed are those that have demonstrated effectiveness in well-designed medical research studies.

Hot Flashes & Night Sweats: Hot Flashes affect about 75% of women after going through menopause. For many women, hot flashes start years before they stop menstruating (stop having a menstrual period) but then get worse after they fully stop menstruating. Hot flashes are often triggered by stress, anxiety or drinking alcohol but most hot flashes occur without any precipitator.

When a hot flash strikes, there's no mistaking it: a women suddenly feels extremely hot inside and often her face flushes and she perspires or sweats. The whole episode usually lasts 3-5 minutes before resolving. Often, a woman will then feel cold after the resolution of the hot flash. Hot flashes that occur at night are called night sweats and are very bothersome for women because of the associated insomnia. Women repetitively will throw the bed sheets off and then back on with each night sweat. Because of the associated insomnia, women with night sweats often feel sleepy during the day and experience impaired concentration and irritability of mood.

Hot flashes are actually neurological symptoms that are caused by the low estrogen levels that naturally occur during menopause. The temperature regulatory center of the body is located in the brain and is very sensitive to estrogen levels. With each hot flash there are dramatic rises in the blood in chemicals that are secreted by the brain.¹

Treatments for Hot Flashes & Night Sweats: Hormone replacement therapy (HRT), made up of estrogen and progesterone medications, is currently the only treatment that has been approved by the US Food & Drug Administration (FDA) specifically for treating hot flashes. In 2002, a landmark study called the Women's Health Initiative showed HRT to be associated with higher rates of breast cancer, heart disease, and stroke.² Because of these significant risks, many women have decided not to take HRT for their menopausal symptoms. Unfortunately, this means that women are left to suffer with their hot flashes, night sweats, and sleeping problems.

Women don't need to suffer. There are 2 safe, non-hormonal medications that have been shown in well-designed medical research studies to be effective for treating hot flashes and night sweats. They are gabapentin and oxybutynin.

Gabapentin has been available since 1994 and is approved by the FDA for treating neuropathic pain, seizures, and restless legs syndrome. Dr. Guttuso discovered gabapentin to effectively reduce hot flashes by accident when treating a woman with gabapentin for her migraine headaches.³ Fascinated by this woman's relief, Dr. Guttuso performed the first well-designed research study that showed gabapentin indeed was effective for treating hot flashes.⁴ Other doctors have subsequently confirmed this exciting finding in 3 other studies.^5-7

CBS Evening News Video Clip

In addition to being an effective treatment for hot flashes and night sweats, gabapentin has also has been shown to greatly improve sleep for women with hot flashes.⁸ The main side effects of gabapentin are sleepiness and dizziness.

Oxybutynin has been available since 1997 and is FDA approved for treating urinary incontinence. There has only been 1 well-designed medical research study published showing oxybutynin to be an effective hot flash therapy.⁹ The main side effects of oxybutynin are dry mouth and constipation.

Are gabapentin and oxybutynin experimental treatments?
No. Gabapentin and oxybutynin are both FDA-approved medications that have been widely prescribed and have a proven safety record since at least 1997. Both medications have also been shown to be effective for treating hot flashes, although neither medication is currently FDA-approved specifically for treating hot flashes.

Doctors frequently prescribe medications for "off-label use" (i.e. for a condition other than the FDA-approved indication) if there is sound evidence that the medication is safe and effective for this other condition.

Gabapentin and oxybutynin certainly meet this standard. Their use for treating hot flashes is not experimental but is based on sound medical evidence and many years of proven safety.

Do the All-Natural, Over-the-Counter Hot Flash Treatments Work?
For most women with hot flashes, the over-the-counter hot flash therapies are ineffective. Some women may experience a few weeks or months of benefit from over-the-counter therapies like soy/isoflavones (eg, Estroven) or black cohosh (eg, Estroven and Remifemin); however, few experience significant, long-term relief from their hot flashes and night sweats.

In general, the Menopause Therapy Center does not recommend the use of these over-the-counter hot flash treatments mostly because there is no good evidence that they are effective. It simply doesn't make sense to spend your money and time on false hope.

About Dr. Guttuso: Dr. Guttuso received his bachelor's degree in 1988 in psychology from Cornell University, his master's degree in 1992 in psychology from the University at Buffalo and his medical degree (MD) in 1996 from the University at Buffalo. He performed his residency in neurology and fellowship in movement disorders at the University of Rochester. He joined the faculty in the department of neurology at the University at Buffalo in 2003. Dr. Guttuso is board-certified in Neurology.

Dr. Guttuso has published his research in reputable journals including Lancet, Obstetrics & Gynecology, Menopause, and Neurology. Most of his research has been funded by the National Institutes of Health (NIH). His research has also been featured in Reader's Digest, Time Magazine, and on CBS Evening News with Dan Rather.

Conclusion: If you are tired of being tired or fed up with being hot and sweaty, you deserve to learn the facts about how you can be helped safely, without the use of hormones.

Call the Menopause Therapy Center in Williamsville, NY (a suburb of Buffalo, NY) for your personal consultation with Dr. Guttuso. Our offices are conveniently located at the Jacobs Neurological Institute at 300 Essjay Road, Suite 100. Call 716-932-6080, option 3 for an appointment

Menopause Therapy Center
Jacobs Neurological Institute
300 Essjay Road, Suite 100
Williamsville, NY 14221
716-932-6080.

View Larger Map

If you live too far from Buffalo, NY to make a visit to the Menopause Therapy Center, click here to access a document that Dr. Guttuso prepared specifically for patients to print and provide to their health care practitioner. This will provide all of the information needed for your practitioner to decide if he or she would like to prescribe one of these medications for you.

References:
1. Genazzani AR, Petraglia F, Facchinetti F, Facchini V, Volpe A, Alessandrini G. Increase of proopiomelanocortin-related peptides during subjective menopausal flushes. Am J Obstet Gynecol 1984;149:775-9.
2. Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Kooperberg C, Stefanick ML, et al. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results From the Women's Health Initiative randomized controlled trial. Jama 2002;288:321-33.
3. Guttuso TJ, Jr. Gabapentin's effects on hot flashes and hypothermia. Neurology 2000;54:2161-3.
4. Guttuso T, Jr., Kurlan R, McDermott MP, Kieburtz K. Gabapentin's effects on hot flashes in postmenopausal women: a randomized controlled trial. Obstet Gynecol 2003;101:337-45.
5. Butt DA, Lock M, Lewis JE, Ross S, Moineddin R. Gabapentin for the treatment of menopausal hot flashes: a randomized controlled trial. Menopause 2008;15:310-8.
6. Pandya KJ, Morrow GR, Roscoe JA, Zhao H, Hickok JT, Pajon E, et al. Gabapentin for hot flashes in 420 women with breast cancer: a randomised double-blind placebo-controlled trial. Lancet 2005;366:818-24.
7. Reddy SY, Warner H, Guttuso T, Jr., Messing S, Digrazio W, Thornburg L, et al. Gabapentin, Estrogen, and Placebo for Treating Hot Flushes: A Randomized Controlled Trial. Obstet Gynecol 2006;108:41-8.
8. Yurcheshen ME, Guttuso T, McDermott M, Holloway RG, Perlis M. Effects of Gabapentin on Sleep in Menopausal Women with Hot Flashes as Measured by a Pittsburgh Sleep Quality Index Factor Scoring Model. J Womens Health (Larchmt) 2009;18:1355-60.
9. Simon JA, LaGuardia KD. Extended-release oxybutynin relieves vasomotor symptoms in healthy postmenopausal women. Obstet Gynecol 2007;109:76S.