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Spray Associated With Reduction in Hot Flash Frequency

While hot flashes are not medically harmful they can be uncomfortable. Some women have hot flashes intense enough to disrupt their daily routines. They can start as a heat spreading through the upper body and face, cause the face to flush, heart rate to increase, and make you sweat. Hot flashes can vary from woman to woman and can be every day or just a few times a week. They can also interfere with your sleep. If the hot flashes are not a major problem, doctors generally recommend lifestyle changes to help decrease side effects. For more severe hot flashes, medication including hormone therapy may be recommended. However, there are some concerns about safety of hormone therapy.

Researchers at Warren Alpert Medical School of Brown University set out to determine the safety and efficacy of a low dose estradiol spray in treating hot flashes. The study, published in the Journal of Obstetrics and Gynecology , found that a low-dose spray may reduce hot flash frequency.

About the Study

The randomized trial followed 454 healthy postmenopausal women. The women had reported eight or more moderate to severe hot flashes. The women were randomly assigned to one of four groups:
  • One daily transdermal spray
  • Two daily transdermal sprays
  • Three daily transdermal sprays
  • Placebo spray

Each spray delivered 90 microliters with 1.53 milligrams of estradiol. The trial ran for 12 weeks. Compared to the placebo group all of the estradiol groups demonstrated a decrease in hot flashes. The groups that had received two or three sprays had significant reduction in severity scores compared with their baseline. There was more than a 50% reduction in hot flash frequency by 74%-85% of the estradiol group compared to only 46% in the placebo group.

How Does This Affect You?

Many women do not need any treatment for hot flashes. If you can manage your hot flashes with lifestyle changes like exercise, avoiding triggers, and relaxation techniques, that is the preferred route. However, if the hot flashes are interfering with your daily routine the estradiol spray may be an option for you. The treatment is meant to be used for a short period of time and the dose is low.

Talk to your doctor about your symptoms and concerns. Discuss treatment options such as lifestyle changes, medication, or alternative treatments. You and your doctor can agree to a plan that works best for you.




  • Buster JE, Koltun WD, Pascual ML, Day WW, Peterson C. Low-dose estradiol spray to treat vasomotor symptoms: a randomized controlled trial. Journal of Obstetrics and Gynecology . 2008 Jun;111(6):1343-51.

Last reviewed December 2008 by Larissa J. Lucas, MD

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