Researchers have compared low-dose oral estrogen and low-dose non-hormonal venlafaxine hydrochloride extended release (XR) to placebo were both found effective in reducing the number of hot flashes and night sweats reported by menopausal women.

Hadine Joffe, MD, MSc, director of the Women's Hormone and Aging Research Program at BWH, and lead author of the paper, said since the publication of the Women's Health Initiative findings, which demonstrated risks associated with ET and led to our current recommendations - that ET be used only at the lowest possible dosage for the shortest possible duration - there has been increased interest in non-hormonal treatments.

In total, 339 perimenopausal and postmenopausal women with bothersome VMS were recruited from the community to Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH), National Institutes of Health (NIH)-sponsored clinical trial network sites between December 5, 2011 and October 15, 2012.

The objective of the study was to determine the therapeutic benefit and tolerability of low-dose estradiol and low-dose venlafaxine in alleviating hot flashes and night sweats. Participants were randomized to double-blind treatment with low-dose treatments for eight weeks. The primary outcome was the daily number of hot flashes and night sweats after treatment. After eight weeks, the frequency of hot flashes/night sweats decreased by 52.9 percent with estradiol, 47.6 percent with venlafaxine, and by 28.6 percent with placebo.

On average, estradiol reduced the frequency of symptoms by 2.3 more per day than placebo, and venlafaxine reduced the frequency of symptoms by 1.8 more per day than placebo. The ameliorative effect on hot flashes/night sweats was statistically significant for each of the medications compared to placebo. Low-dose estradiol reduced the frequency of symptoms by 0.6 more per day compared to venlafaxine on average, although this difference was not statistically significant. While the benefit of low-dose estradiol was found to be slightly superior to venlafaxine in this study, the difference was found to be small and likely of limited clinical relevance.

The study has been published in the JAMA Internal Medicine.