Flaxseed of no use in menopausal hot flashes: Study

By Dr. Ananya Mandal, MDJun 7 2011

Flaxseed has been the latest agent that has been tried in treating menopausal hot flashes and it is seen that it does not reduce the incidence of the unpleasant symptoms.

The new findings were presented Sunday at the annual meeting of the American Society of Clinical Oncology in Chicago where the researchers report that a daily flaxseed bar was no more effective than a placebo in helping with hot flashes in women with or without breast cancer.

Dr. Joanne E. Mortimer, director of women's cancers programs at City of Hope Cancer Center in Duarte, California said, “It's unfortunate because these are such common problems, not just in breast cancer survivors but in postmenopausal women in general. These poor women have one less option.” She was an independent observer. Dr. Erica L. Mayer, a breast oncologist with Dana Farber Cancer Institute in Boston, who also was not involved with the new research said, “Women who are taking endocrine (hormone) therapy and have significant side effects may be less likely to be adherent to treatment, and that leads to worse outcomes.”

It is known than hot flashes often occur in breast cancer patients who have undergone hormonal treatment for their tumors as well as in women going through normal menopause. Estrogen therapy has been shown to be effective in reducing the incidence of hot flashes but not without a hefty health cost, including a heightened risk of stroke and blood clots. Flaxseed contains lignans, which can work against estrogen it is speculated. Mayer explained, “Anecdotally it (flaxseed) has been thought to improve hot flashes and they (the researchers behind the new study) had some pilot data from a non-randomized trial that women who took flaxseed had decreased hot flashes. That led to the current trial.”

For this study 188 postmenopausal women who reported having at least 28 hot flashes a week were randomly selected to receive either a placebo or a daily flaxseed bar for six weeks. About half of the women had had breast cancer and half had not. Results showed that both groups of women reported declines in the number of hot flashes they were experiencing, that number was about the same in each group, with about a third in each group reporting a 50% reduction in symptoms.

There were also side effects in both groups, namely bloating, diarrhea and nausea, most likely due to the fiber in the placebo and flaxseed bars, said study author Sandhya Pruthi, an associate professor of medicine at the Mayo Clinic in Rochester, Minn.

Pruthi said the results were “surprising” because a preliminary trial she conducted appeared to show benefit. That initial study, however, was not placebo controlled. She said, “Flaxseed may be a highly touted supplement for many ills but according to our randomized study results, it is not effective for hot flashes.”

Mortimer said, “This is a much more complex brain process that we need to understand. Negative studies like this (should) spur us on to find the biological mechanisms behind this (hot flashes). Right now, we don't even know the mechanisms.” Various antidepressants such as Effexor and Zoloft have been shown to be effective against hot flashes, as has acupuncture, said Mayer adding, “This is a disappointing study in that it didn't confirm what we had previously seen, but it supports further high-quality, ongoing research to identify agents which are well-tolerated, acceptable to patients and effective in reducing hot flashes so they can stay on therapy and have better breast cancer outcomes.”