Skip to content


    Exciting News for WebMD Members!

    We've been busy behind the scenes building new message boards for you. You'll have new and easier ways to find messages, connect with others, and share your stories.

    And, this will all be available on your smartphone or other mobile device!

    What Do You Need to Do?

    The message board you're used to will be closing in the coming weeks. While many of your boards will be making the move to our new home, your posts will not. Want to keep a discussion going? Save posts you want to continue (this includes your member profile story), so that you can re-post them in the new message boards.

    Keep an eye here and on your email inbox, we'll be back in touch soon to give you all the information you need!

    Yours in health,
    WebMD Message Boards Management

    Includes Expert Content
    USAKDOG posted:
    I am 54 years old and postmenopausal. No period for 5 years. I was on HRT for two and a half years and stopped. Recently I have been experiencing severe hot flashes and some severe anxiety. I talked with nurse practitioner that stated that menopausal symptoms can return when HRT was used in the onset. She suggested an anti-depressant, Celexa, which my pharmacist said was not a good choice. What other options do I have that would be safer to help me through this.
    Mary Jane Minkin, MD responded:
    Dear USAKDOG,
    Unfortunately, some women do experience persistent hot flashes. About 15% of women have moderate to severe hot flashes that can last for over 10 years. For women who do not choose to remain on hormone therapy, there are other options. For over the counter remedies, my patients have had the best responses to Remifemin (black cohosh) and "Icool", which contains isoflavones, which are weak plant estrogens (like soy). Of non hormonal options, SSRI and SNRI antidepressants do work well for many women; a new medication has just been approved, and will be available in the fall, called Brisdelle; it is a very low dose of the antidepressant Paroxetine, which seems to avoid some of the annoying side effects of SSRI's, with its low dose, but does give hot flash relief. Celexa is quite a reasonable SSRI; I'm not sure why your pharmacist nixed it. The other choice of categories is the drug Gabapentin (neurontin)-used at night, it can help with hot flashes and sleep. The major drawbacks to the antidepressant category and Gabapentin are possible side effects; so you want to be working with your health care provider to help you.
    Good luck,
    Mary Jane
    USAKDOG replied to Mary Jane Minkin, MD's response:
    I was just wondering if your patients found relief from the anxiety with the Remifemin or "I Cool". That is really my major problem. I would like to avoid the antidepressants.
    Mary Jane Minkin, MD replied to USAKDOG's response:
    Dear USAKDOG,
    Some have; and it's certainly worth a try. Of course, if you just have occasional anxiety, you could consider taking an occasional dose of a medication such as Xanax or Ativan. But I'd give the Remifemin and Icool a chance.
    Good luck,
    Mary Jane

    Featuring Experts

    Mary Jane Minkin, MD, is a nationally recognized obstetrician gynecologist, with a special interest in menopause. Dr. Minkin is clinical professor of ...More

    Helpful Tips

    Fact or fiction? Estrogen therapy is an option for all menopausal womenExpert
    Fiction: Only women who no longer have a uterus should consider using esdtrogen-alone therapy (ET). For women with a uterus, the option ... More
    Was this Helpful?
    33 of 47 found this helpful

    Related Drug Reviews

    • Drug Name User Reviews

    Report Problems With Your Medications to the FDA

    FDAYou are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.

    For more information, visit the North American Menopause Society website