Treatment of menopausal flushes with oral clonidine

Abstract

Clonidine, an alpha 2-adrenergic agonist, has been shown to ameliorate hot flushes by decreasing noradrenergic activity in the blood vessels. The effectiveness of low doses of oral clonidine in reducing the number of episodes, duration, and intensity of menopausal flushes was evaluated in 25 Chinese women. The 15 menopausal women in the treatment group (mean age, 49.8 ± 1.4 years) took one 25-μg tablet of clonidine twice daily for 3 weeks. If symptoms did not improve after 1 week, the dose was increased to 2 tablets twice daily and then to 2 tablets three times daily. The 10 menopausal patients in the control group (mean age, 47.1 ± 2.3 years) took no medication. The frequency, duration, and intensity of hot flushes were significantly decreased after the second week of clonidine treatment. Neither blood pressure nor pulse rate changed significantly during clonidine therapy. Adverse effects were minimal. Only one patient each reported nausea, dizziness, and dry mouth, and these side effects disappeared spontaneously during the treatment period. Because estrogen replacement therapy is contraindicated in menopausal women with or at high risk for endometrial or breast cancer, low-dose clonidine treatment provides a nonhormonal alternative for relieving menopausal flushes in this patient population, as well as in menopausal women in general.