Elephants And Tea - March 2021 - 36

Sexuality

INTIMATE ISSUES WITH MARLOE

Complementary and Alternative Medicines (CAMs)
Many people prefer natural methods of managing hot flashes and look for alternatives to prescription medicines.
CAMs encompass a wide variety of interventions, from herbs and supplements to integrative and mind-body therapies.
Unfortunately, a lot of the CAMs used for hot flashes have not been subjected to rigorous scientific studies, making it
difficult to draw conclusions regarding safety and efficacy. A great resource for more in-depth information regarding
the role of CAMs in treating menopausal symptoms can be found at the National Center for Complementary and
Integrative Health (NCCIH)4 website.
Non-Prescription Vitamins, Supplements, and Herbal Remedies
Examples of over-the-counter (OTC) vitamins, dietary supplements, and herbal treatments sometimes used for hot
flashes include: botanicals (such as maca and evening primrose), phytoestrogens (such as soy and isoflavones), vitamin
E, flaxseed oil, St. John's wort, Chinese herbal remedies, and black cohosh5,6,7. The general lack of regulation and oversight of these products calls into question their quality, and many have not been studied well enough to understand
their true effectiveness or possible harms (especially in people with a history of cancer), which can include unknown
interactions or toxicities. Due to such concerns, experts typically caution against these alternative options2,5,6,7.
Also, when it comes to weighing risks and benefits, not all of these options are created equal. Some may
have a relatively a low likelihood of harm (like low-dose vitamin E7, for example), while others may have potentially severe toxicities or adverse effects (such as black cohosh5). Before trying any OTC remedies, seek the
guidance of your provider.
Integrative Therapies
Several mind-body therapies have shown some promise in small studies and may be beneficial in relieving hot flashes.
These include cognitive-behavioral therapies (CBT), mindfulness-based stress reduction (MBSR), paced breathing
exercises, acupuncture, clinical hypnosis, and yoga5,6,7.
Unlike the safety concerns associated with many supplements and herbal treatments, there appears to be
little if any risk related to participating in mind-body integrative therapies4, which may make them better
alternatives to explore. However, more high-quality research is still needed before many of these options become standard-of-care.
THE BOTTOM LINE
You are not alone! Hot flashes are a part of the cancer experience for many AYAs, but you don't have to accept feeling
miserable. Report your symptoms to your care team and ask for help creating an individualized plan for managing
them. It may take a combination of some of the above options, as well as a few different tries to find interventions
that work.
If your ovarian function resumes when you are done with treatment, your hot flashes may resolve. However,
treatment can cause permanent early menopause. If this is your situation, the guidance of an expert can help
you deal with menopausal symptoms. Ask your provider for a referral to a specialist who is familiar with the
needs of young women facing early menopause, or use the " Find a Menopause Practitioner " search on the
North American Menopause Society's website to locate someone in your area.

References:
1.	 Foley, S., Kope, S., & Sugrue, D.
(2012). Sex matters for women: A
complete guide to taking care of
your sexual self (2 ed.). Guilford
Press.
2.	 Kaplan, M., Ginex, P. K., Michaud,
L. B., Fernández-Ortega, P., Leibelt,
J., Mahon, S., Rapoport, B. L.,
Robinson, V., Maloney, C., Moriarty,
K. A., Vrabel, M., & Morgan, R. L.
(2020). ONS guidelines™ for cancer
treatment-related hot flashes in
women with breast cancer and
men with prostate cancer. Oncology
Nursing Forum, 47(4), 374-399.
https://doi.org/10.1188/20.
ONF.374-399
3.	 Kelly, L. (2020). The menopause
transition. In D. M. Schadewald,
U. A. Pritham, E. Q. Younkin, M. S.
Davis, & C. Juve (Eds.), Women's
health: A primary care clinical
guide (pp. 410-443). Pearson
Education, Inc.
4.	 National Center for Complementary
and Integrative Health. (2017).
Menopausal symptoms: In depth.
https://www.nccih.nih.gov/health/
menopausal-symptoms-in-depth
5.	 National Comprehensive Cancer
Network. (2020, July 14).
Survivorship. NCCN Clinical Practice
Guidelines in Oncology. Retrieved
from https://www.nccn.org/
professionals/physician_gls/pdf/
survivorship.pdf
6.	 North American Menopause Society.
(2015). The menopause guidebook
(8 ed.).
7.	 Santen, R. J., Loprinzi, C. L.,
& Casper, R. F. (2020, April
27). Menopausal hot flashes.
UpToDate. https://www.uptodate.
com/contents/menopausal-hotflashes?search=vasomotor%20
symptoms&source=search_
result&selectedTitle=1~150&usage_
type=default&display_rank=1
8.	 Shifren, J. L., Gass, M. L. S.,
Kagan, R., Kaunitz, A. M., Liu, J.
H., Pinkerton, J. A. V., Schnatz, P.
F., Stuenkel, C. A., Allam, S. H.,
Allen, R. H., Bachmann, G. A., Merz,
C. N. B., Bergfeld, W. F., Block,
J. A., Clarkson, T. B., Clayton, J.
A., Cwiak, C., Davis, S. R., Diab,
D., ... Schiff, I. (2014). The North
American Menopause Society
recommendations for clinical care of
midlife women. Menopause, 21(10),
1038-1062. https://doi.org/10.1097/
gme.0000000000000319

M A R L OE E S C H, R N, B SN, ONC OL O GY C E RT I F I E D N U R SE (O C N), A N D YOU NG A DU LT
C A NC E R SU RV I VOR , GR A DUAT E D F ROM T H E U N I V E R SI T Y OF W IS C ONSI N - M A DIS ON
S C HO OL OF N U R SI NG (G O BA D GE R S!) I N 2 0 0 8 . SH E E N JOYS E DUC AT I NG B OT H
SU RV I VOR S A N D H E A LT HC A R E PROF E S SIONA L S ON T H E TOPIC OF C A NC E R A N D
SE X UA L I T Y, A N D H A S PR E SE N T E D FOR T H E YOU NG SU RV I VA L C OA L I T ION, T H E
ONC OL O GY N U R SI NG S O C I E T Y, A N D PL A N N E D PA R E N T HO OD OF W I, A MONG
OT H E R S . SH E HOL DS A C E RT I F IC AT E F ROM T H E SE X UA L H E A LT H C E RT I F IC AT E
PRO GR A M T H ROUGH T H E U N I V E R SI T Y OF M IC H IG A N A N D IS C U R R E N T LY PU R SU I NG
H E R D O C TOR OF N U R SI NG PR AC T IC E (DN P) AT T H E U N I V E R SI T Y OF W IS C ONSI N -
M I LWAU K E E . A N E N T H USI A S T IC SU PP ORT E R OF SE X UA L H E A LT H A N D W E L L N E S S ,
M A R L OE IS M A K I NG I T H E R M IS SION TO BR I NG SE X I N TO T H E SU RV I VOR SH I P
SP OT L IGH T.

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https://www.nccih.nih.gov/health/menopausal-symptoms-in-depth https://www.nccih.nih.gov/health/menopausal-symptoms-in-depth https://www.doi.org/10.1188/20.ONF.374-399 https://www.doi.org/10.1188/20.ONF.374-399 https://www.nccih.nih.gov/health/menopausal-symptoms-in-depth https://www.nccih.nih.gov/health/menopausal-symptoms-in-depth https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf https://www.nccn.org/professionals/physician_gls/pdf/survivorship.pdf https://www.uptodate.com/contents/menopausal-hot-flashes?search=vasomotor symptoms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 https://www.uptodate.com/contents/menopausal-hot-flashes?search=vasomotor symptoms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 https://www.uptodate.com/contents/menopausal-hot-flashes?search=vasomotor symptoms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 https://www.uptodate.com/contents/menopausal-hot-flashes?search=vasomotor symptoms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 https://www.uptodate.com/contents/menopausal-hot-flashes?search=vasomotor symptoms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 https://www.uptodate.com/contents/menopausal-hot-flashes?search=vasomotor symptoms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1 http://www.menopause.org/for-women https://www.doi.org/10.1097/gme.0000000000000319 https://www.doi.org/10.1097/gme.0000000000000319

Elephants And Tea - March 2021

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