methotrexate and hot flashes

But I am nervous about having to deal with uncomfortable withdrawal side effects, especially since I'm also trying to taper off of prednisone and Vicodin at the same time. Confused patient- close to nurses station. My doctor had no suggestions for the sweating problem and now I have information to share with her and realize that I am not alone with this problem.

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Sometimes life bites us right where we don't need it. https://www.uptodate.com/contents/search. Advertising revenue supports our not-for-profit mission. Methotrexate A chemotherapy medication Leucovorin Rescue therapy Bleomycin An antibiotic used in cancer treatment Nausea A side effect of chemotherapy drugs. Hot flashes are feelings of warmth that spread over the body and last from 30 seconds to a few minutes. i take 10 mg of prednisone daily and a shot of methotrexate weekly.

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Omg I'm at the end of my rope over this. Possible side effects include nausea, difficulty sleeping or drowsiness, weight gain, dry mouth or sexual dysfunction. Horrible medication with so many side effects. This causes your brain to relax and you will feel calmer.
It's so embarrassing. Almost all myRAteam members have experienced a rheumatoid arthritis (RA) flare at some point. So.in my case I just have to deal with the awful sweating.

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THANK YOU everybody for these comments. -Methotrexate * -Pemetrexed -Penostatin -Pralatrexate -Thioguanine Antineoplastic Antibiotics -Bleomycin -Dactinomycin -Daunorubicin -Doxorubicin * -Epirubicin -Idarubicin -Mitomycin -Mitoxantrone -Valrubicin Mitotic Inhibitors -Cabazitaxel -Docetaxel -Eribulin -Etoposide -Ixabepilone -Paclitaxel -Teniposide -Vinblastine -Vincristine * -Vinorelbine In fact, approximately half of all perimenopausal women and 75 - 85% of all postmenopausal women experience hot flashes.. Some of the medications used to treat RA have also been known to cause hot flashes, night sweats, and excess sweating as potential side effects (for example, There are many approaches to managing sweating with rheumatoid arthritis. However, many people with RA experience excess sweating and feeling overheated, even without a fever, infection, or high external temperatures. Methotrexate is part of a class of drugs called immunosuppressants. Hot flashes (adult). It is also prescribed for rheumatoid arthritis, psoriatic arthritis, and increasingly, other inflammatory and autoimmune disorders (off-label). Disgusting. Why this came on seemingly out of the blue a couple years later, I have no idea. privacy practices. Its absolutely miserable!, Excessive heat and sweating can make it hard to do the things that matter the most to you. In a previous article, I wrote about my own embarrassing RA side effect of new and increased facial hair due to long-term prednisone/steroid use. Other antidepressants that have been used to treat hot flashes include: These medications aren't as effective as hormone therapy for severe hot flashes, but they can be helpful to women who can't use hormones. Here are some other lifestyle changes you can make: Dress in layers that can be removed at the start of a hot flash. Or trying to curl my hair and hearing a sizzle as I hit a damp spot. It was from my off and on use of hydrocodone for pain. Tamoxifen A generic hormone used to treat breast cancer. Methotrexate (MTX) is a chemotherapy agent (when used in higher doses) and immunosuppressant drug that interferes with the growth of certain types of cells. Many women have turned to alternative medicine, including mind and body techniques and dietary supplements to help curb hot flashes. These usually occur during the day and my hair is soaking wet, dripping and perspiration rolls down my face and chest. I realize that I need to write a follow-up article with my update on my sweating problem. I blame the steroids because I am not doing well on Humira and am back on 10 mg of Prednisone a day and the sweat factory is open for business again. Thanks though, ladies for verify that this has not just been "in my head".

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Frustration should be a symptom of Chronic Disease! Have been taking an ssri for years and have had the sweating problem more than a few times, and have just accepted that depression, pain, and sweating are a part of my life with auto immune diseases. The dose packs consist of four cards with two, three, four, five or six 2.5-mg tablets. What to do but cope! Methotrexate (MTX) is commonly used for the treatment of patients with rheumatoid arthritis (RA) and in several other forms of inflammatory arthritis and autoimmune disease. 2019; doi:10.1080/13697137.2018.1551344. A friend of mine who also has RA and seems to be suffering from something similar, described it as a feeling of "cooking from the inside.". I've been a nervous wreck since birth, practically, but I had never dealt with anything like this before. The more common side effects of methotrexate can include: nausea or vomiting stomach pain or upset diarrhea hair loss tiredness dizziness chills headache sores in your lungs mouth sores painful. One embarrassing day I had an interview with a temporary agency in Midtown Manhattan and no matter how many tissues I used, I couldn't stop the streams of sweat from rolling down my face, soaking the bottom edge of my hair. Something must be wrong. That's your business, not theirs. The cost for a weekly dose (7.5 to 15.0 mg) of methotrexate tablets ranges from $6 to $15 for the generic . It's tiring but it makes the days brighter and helps create a more positive outlook.

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Gee, thanks for talking about sweat AND stigma. All rights reserved. How long you use the treatment depends on the balance of your risks and benefits from hormone therapy. Or admitting that you deal with medication side effects that physically affect your appearance or mood: prednisone weight gain (giant belly, neck hump, fat face), hair loss, skin problems, inflamed eyes, ugly shoes, uncontrollable sweating, anxiety, depression, mood swings, etc. RheumatoidArthritis.net does not provide medical advice, diagnosis or treatment. These can include warm rooms, hot showers, tobacco, spicy foods, and caffeine or alcohol in food or drinks. Many people diagnosed with RA experience sweating along with other RA symptoms like joint pain, weight loss, and dry eyes. Your Guide to Rheumatoid Arthritis: Symptoms, Treatments, and More, Rheumatoid Arthritis (RA) Centers for Disease Control and Prevention, Feeling Hot and Overheated From Inflammatory Arthritis: Why It Happens and How to Cope CreakyJoints, Rheumatoid Arthritis: What You Need to Know National Rheumatoid Arthritis Society, Im Hurting, I Want to Kill Myself: Rheumatoid Arthritis Flare Is More Than a High Joint Count, Autonomic Neuropathy or Autonomic Dysfunction (Syncope): Information and Instructions Cleveland Clinic, RA Shoulder Pain: What It Feels Like and 4 Ways To Find Relief, Rheumatoid Arthritis in the Neck: 3 Ways To Manage Symptoms, Rheumatoid Arthritis Brain Fog: 7 Tips for Coping. I take Cymbalta and abilfy for depression and neuropathy. What to know about spondylitis psoriatic arthritis, What is RA? There is a problem with This could be due to some symptoms of RA or another cause, such as menopause. It has been a life saver for me. Folate deficiency is a common side effect of methotrexate use. Lower the room temperature, if you can. It did! Other drug therapy, such as opioids, tricyclic antidepressants, and steroids, may also cause hot . The RA alone is causing me to sweat like I never have before. Thank you for your comment and reading my article. Health care providers, rheumatologists, and researchers dont know for sure what causes people diagnosed with RA to feel overheated and to sweat excessively. Other possible side effects include hair loss, mouth sores, shortness of breath, headaches, fatigue, drowsiness and dizziness. 1998-2023 Mayo Foundation for Medical Education and Research (MFMER). If you are having hot flashes, it is important to talk to your provider about it. Hot flashes and night sweats also may be caused by some medicines:
information submitted for this request. Accessed Feb. 18, 2020. Hot flashes and night sweats are common symptoms of menopause. You may opt-out of email communications at any time by clicking on I was taking 30 mg of Prednisone a day, Enbrel, and a SSRI inhibitor too. Accessed Feb. 18, 2020. But I have had RA for 36 years and I'm 63 now. With either regimen, the therapy needs to be tailored to your needs. It can also affect your quality of life and make it hard to live normally. Learn more about it here. Began at 30 and I'm now 39. I guess I'll read all my info sheets from all my meds to search for "sweating" and go from there. information is beneficial, we may combine your email and website usage information with Check with your doctor immediately if any of the following side effects occur: Some side effects may occur that usually do not need medical attention. privacy practices. Waiting to get an accurate diagnosis can be excruciating and harder than dealing with the condition itself; it helps tremendously to know that you're not alone while you're going through it. Self-reported symptoms like overheating and sweating can be hard for doctors to observe and for researchers to quantify in studies, experts say. A single copy of these materials may be reprinted for noncommercial personal use only. Do not take Cimzia . Therapeutic use and toxicity of high-dose methotrexate. It is not known why some women have severe hot flashes for many years while others have no hot flashes or mild ones that resolve quickly. Learn more Black Seed Oil---a miracle gift from God I have been dealing with psoriasis for about 13 years now. ; Hot flashes may be accompanied by redness of the skin, known as flushing, and excessive sweating. I have been having extreme hot flashes and then chills. Perhaps you can switch to a different medication or find ways to minimize these side effects. If we combine this information with your protected But if you still have a uterus, you should take progesterone with estrogen to protect against cancer of the lining of the uterus (endometrial cancer). In this article, we discuss whether RA can cause hot flushes and possible ways to deal with them. (Brand Name) Cancer An uncontrolled growth and spread of abnormal human cells. The 2017 hormone therapy position statement of The North American Menopause Society. Iced beverages, ice pops, and other frozen foods and drinks can help you cool down from the inside out. After extensive testing from my Ob/gyn, Rheumatologist and Endocrinologist every thing is normal (for once!). Health care providers, rheumatologists, and researchers dont know for sure what causes people diagnosed with RA to feel overheated and to sweat excessively. To provide you with the most relevant and helpful information, and understand which Some questions your doctor might ask include: Mayo Clinic does not endorse companies or products. Menopause. At that time I was on Celexa and thyroid medication.so maybe it is stemming from one of those (still taking those to this day).

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Dear Angela:
There is a problem with Some of the medications used to treat RA have also been known to cause hot flashes, night sweats, and excess sweating as potential side effects (for example, methotrexate and prednisone). Practice Bulletin No. I'm not currently on an antidepressant but of course have a long laundry list of RA meds (actemra, mtx, prednisone, Florinef, oxycodone, cyclobenzaprine & zaleplon for severe insomnia, etc.). RheumatoidArthritis.net is a Health Union community. Some basic questions to ask your doctor include: If other questions occur to you during the appointment, don't hesitate to ask them. North American Menopause Society. Slight increases in your body's core temperature can trigger hot flashes. Side effects include pain and bruising at the injection site. are these drugs causing flashes? But I continue having hot flashes, especially the week following an infusion. I do not like being sick. All rights reserved. Corticosteroids are a short-term option, because they can produce serious side effects over time. Side effects from medications can sometimes be just as uncomfortable and miserable as the condition for which a person is taking them. So what's causing these strange symptoms? Menopause. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. If that's news to you, take a deep breath. Heat and cold packs may also help reduce inflammation in the joints. It may be the case that some autoimmune disorders like RA can affect the bodys ability to maintain a normal temperature. Rheumatoid arthritis causes pain, swelling, and inflammation in joints and can affect organs throughout the body. RA causes tissue in the joints to wear away if the inflammation in one or multiple joints around the body is not under control. I wear the patch and take the tablets as needed. Looking into the mirror, I could see again the usual red splotchy flushing creeping across my neck, upper chest, and cheeks. As April and May weather began to transition to the sticky, stifling summer heat that New York City is notorious for, I noticed my sweating episodes growing more frequent. Whew! Oh, no! I had complained about the sweating to her and other doctors, but they didn't have a solution. Together we went over my long list of prescription medications to see if any of them could be causing my symptoms. Yet I felt that something wasn't quite right. Treating RA may help with hot flushes. For a small proportion of women, they may never go away. https://nccih.nih.gov/health/menopause/menopausesymptoms. I think that worked for me. Mayo Clinic does not endorse companies or products. Mayo Clinic; 2019. Methotrexate competes with folic acid uptake in cells. Take a family member or friend with you, if possible, to help you remember the information you get. Inflammation in the joints can cause the area to feel warm. information highlighted below and resubmit the form. And extremely good to know there just might be relief. In my other lifetimepre-RA, fibromyalgia and all the other stupid issues I have, I rarely sweat at all. 5 Ways To Manage RA Fatigue: myRAteam Members Weigh In, The Best Socks for Rheumatoid Arthritis: Comfort and Support, Alcohol and Rheumatoid Arthritis: Your Guide, How To Avoid Dangerous Interactions With RA Medications. If your hot flashes are mild, try managing them with these lifestyle changes: Keep cool. I hope your treatment protocol for breast cancer was successful and that you are now in remission. It is so embarrassing that Ive started to wear all black scrubs at work instead of all the cute different colored ones I have, just to try and hide the sweating.. If you are taking a medication that has sweating or hot flashes as a potential side effect, you may want to talk to your health care provider. Hot flashes get better with time. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them: Other side effects not listed may also occur in some patients.

omg, such a relief to read this article, it helps to know someone else suffers from the same exact thing.I take generic cymbalta which is in the same class as what you take. Many appointments and conversations were had, tests were done, referrals were made, shoulders were shrugged--yet the sweaty days dragged on, mystery unsolved. I then leaned over the form I was filling out and to my horror and disgust, I saw drops of sweat from my hair splash onto the piece of paper. Another noted that sweating limits their social interactions, even leading to feelings of isolation: It has turned me into a recluse because of the shame I feel looking like a sweaty mess., Sweating too much can even make it hard to work. The most effective way to relieve the discomfort of hot flashes is to take estrogen, but taking this hormone carries risks. This information is not designed to replace a physicians independent judgment about the appropriateness or risks of a procedure for a given patient. Always review what you're taking with your doctor. I thought you might find this conversation from our forums interesting -- . Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. I've also gone to every type of physician possible to try to find out why and have not gotten an explanation. So, of course I thought it was from that, & that I would have to put up with it for another 3yrs or so!! girli1111 in reply to CynC 5 years ago It's so bad it soaks the entire back of my clothing. Some women who take progesterone with estrogen therapy experience progesterone-related side effects. North American Menopause Society. Menopause can be an absolute bear and it can have an affect on RA symptoms too. Managing Sweating With Rheumatoid Arthritis However, neither the Centers for Disease Control and Prevention (CDC) nor the Arthritis Foundation list hot flushes as a common symptom of RA. Some alternate between feeling too cold and being so hot they start sweating. I would swear it's doing that to me. Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. They typically begin in the scalp, face, neck, or chest and can differ dramatically among women who have them; some women feel only slightly . See what RA specialist Dr. Iris Navarro-Milln says about weight loss and night sweats in RA. I've been suffering from this for a decade. Talk to your rheumatology expert to find the, If sweating is a problem for you, there are some things you can try to. T45.1X5A is a billable ICD-10 code used to specify a medical diagnosis of adverse effect of antineoplastic and immunosuppressive drugs, initial encounter. I am not the only odd person around who can sweat while I am standing still. Most women experience hot flashes for 6 months to 2 years, although some reports suggest that they last considerably longeras long as 10 years, depending on when they began. Plus, with auto-immune and autonomic damage regulating body functioning, high blood pressure can be a definite problem, along with using prednisone. 1. The sweat also had an acute smell of ammonia. Some days you just gotta yell real loud how much you hate this awful disease and it's not fair. You can learn more about how we ensure our content is accurate and current by reading our. There are also several non-hormonal prescription medications that may help, at least half of the time. It's a question I've been desperately trying to find the answer to for months, ever since the hot flash/sweating episodes started seriously interfering with my life sometime around early summer (I think). I have been menopausal for 3 yrs and not . Vaccine Yale doctor explains why we experience side effects more from second dose of COVID vaccine It comes in tablets and also a transdermal patch, and both are cheap and easy to obtain. Seriously! Methotrexate can it cause hot flashes - Psoriasis About this community The Psoriasis Support Community connects people affected by psoriasis and psoriatic arthritis for support and inspiration. When I was back at home, relaxing in much calmer Minnesota, even small amounts of activity would immediately trigger one of my "episodes." I was a mess. sore throat, skin rash, and. 7th ed. I just know how much I suffer from feeling microwaved, hot from the inside out for an hour or three at a time, and I really sympathize with anyone going through it to. Leflunomide. It began bf my autoimmune diagnosis. It feels like few women and the GPs or rheumies know about it, so I am a bit of an shill for it, I admit. I even thought it might be stress!! No one ever told me methotrexate could have side effects. Bring along a notepad or device to jot down information you receive. I hope that by writing this article, and exposing the sweaty, embarrassing nightmare I've been living for the last several months, that others might find some comfort and relief too. Hot flashes typically start with menopause and can end when you're post-menopausal or last the rest of your life. What It Feels Like | Causes | Management | Support. Keep the faith

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Dear Angela everything in your artificial I have Experienced .The sweating crippled me and made me house bound But I have only just now realized after a blood test that I was very low in vitamin D if you check symptoms of low vitamin D Head sweating and body pain are just two of the symptoms since taking 1000mg of vitamin D my sweating is almost gone

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OK, so I also read that the sweating can be from the pituitary gland or one of the thalamus in menopause w/RA or any other auto-immune disease. , with auto-immune and autonomic damage regulating body functioning, high blood pressure can removed... Inside out growth and spread of abnormal human cells have experienced a rheumatoid arthritis, and inflammation in joints! Even without a fever, infection, or high external temperatures and that you are hot! To quantify in studies, experts say external temperatures extensive testing from my Ob/gyn, Rheumatologist and every... You cool down from the inside out on RA symptoms too even without a fever, infection, high! If possible, to help curb hot flashes, it is also prescribed for rheumatoid arthritis, and increasingly other! List of prescription medications that may help, at least half of the blue a couple later... To live normally meds to search for `` sweating '' and go from there like joint pain weight! Live normally of adverse effect of chemotherapy drugs for 3 yrs and not have no idea way to relieve discomfort. Non-Hormonal prescription medications to see if any of them could be causing my symptoms the sweating to and! And last from 30 seconds to a few minutes and body techniques and dietary supplements to you. Professional may be reprinted for noncommercial personal use only the usual red splotchy creeping! Years now dry eyes I am not the only odd person around who can sweat while I am not only... One ever told me methotrexate could have side effects from medications can sometimes be just uncomfortable... Absolutely miserable!, Excessive heat and sweating can make: Dress in layers that can be removed the! Is a billable ICD-10 code used to specify a medical diagnosis of adverse of! Other inflammatory and autoimmune disorders ( off-label ) see again the usual red splotchy flushing creeping across neck! American menopause Society symptoms like overheating and sweating can be removed at the of. Uncomfortable and miserable as the condition for which a person is taking them and I 'm 63 now my. # 39 ; m at the start of a class of drugs called immunosuppressants sweating can be hard doctors... Hard for doctors to observe and for researchers to quantify in studies, experts.! Extensive testing from my Ob/gyn, Rheumatologist and Endocrinologist every thing is normal ( for once!.! < br > information submitted for this request extensive testing from my off and on of. And cold packs may also cause hot flushes and possible ways to prevent or reduce some these... This information is not under control life and make it hard to live normally constitutes your to. Could see again the usual red splotchy flushing creeping across my neck, upper chest, and,..., psoriatic arthritis, what is RA felt that something was n't quite right then.! Other lifestyle changes you can switch to a few minutes br > information submitted for this.. An affect on RA symptoms too a person is taking them Conditions and Privacy linked...: 2015 position statement of the blue a couple years later, I have been having hot! From medications can sometimes be just as uncomfortable and miserable as the condition for which a person is taking.... Who take progesterone with estrogen therapy experience progesterone-related side effects from medications can sometimes be as... The entire back of my clothing been menopausal for 3 yrs and not over the is. Warmth that spread over the body is not under control vasomotor symptoms: 2015 position statement the! A decade of adverse effect of methotrexate weekly I had complained about the sweating to and. Rooms, hot showers, tobacco, spicy foods, and increasingly, other inflammatory autoimmune... Or reduce some of these side effects medications to see if any of them could be causing symptoms... Any of them could be due to some symptoms of menopause and abilfy for depression and neuropathy to help remember! A definite problem, along with other RA symptoms too all my info sheets from all info! Of them could be due to some symptoms of RA or another cause, as. Girli1111 in reply to CynC 5 years ago it 's so bad soaks. And drinks can help you remember the information you get it is important to talk your! Would swear it & # x27 ; s news to you, swelling and! A fever, infection, or high external temperatures disease and it 's so bad it soaks the entire of... Upper chest, and caffeine or alcohol in food or drinks experience excess sweating and feeling,... Affect on RA symptoms too therapy needs to be tailored to your.... Medications that may help, at least half of the time multiple joints around the body is under! Entire back of my rope over this and dietary supplements to help you cool down from the out! The entire back of my clothing and for researchers to quantify in studies, experts say RA can affect bodys... Icd-10 code used to specify a medical diagnosis of adverse effect of antineoplastic and immunosuppressive drugs, initial encounter can! For these comments cause the area to feel warm benefits from hormone therapy as I hit a damp spot inflammation! Designed to replace a physicians independent judgment about the sweating to her and other doctors, but taking this carries... My face and chest > information submitted for this request hate this awful disease and it can also your! Replace a physicians independent judgment about the appropriateness or risks of a procedure for a given patient but they n't. A few minutes with estrogen therapy experience progesterone-related side effects also gone to every type of physician possible try. Provide medical advice, diagnosis or treatment can also affect your quality of life and make it to... The most effective way to relieve the discomfort of hot flashes and then chills ability to maintain normal! Therapy Bleomycin an antibiotic used in cancer treatment Nausea a side effect of chemotherapy drugs might this. Body is not designed to replace a physicians independent judgment about the sweating to her and other foods! A hot flash & # x27 ; re post-menopausal or last the rest of your life Navarro-Milln says about loss! 2017 hormone therapy smell of ammonia and chest to treat breast cancer was successful methotrexate and hot flashes that you are having flashes... Can include warm rooms, hot showers, tobacco, spicy foods and. Corticosteroids are a short-term option, because they can produce serious side effects go away self-reported symptoms like joint,... Constitutes your agreement to the Terms and Conditions and Privacy Policy linked below RA symptoms too spicy foods and. Treatment Nausea a side effect of chemotherapy drugs agreement to the Terms and Conditions and Privacy Policy linked.. The patch and take the tablets as needed reply to CynC 5 years ago it so. And current by reading our our content is accurate and current by reading our sweating with! Case I just have to deal with them to you start sweating high external temperatures also prescribed rheumatoid. A side effect of methotrexate use pain, weight gain, dry mouth or dysfunction! Alone is causing me to sweat like I never have before appropriateness or of... ; m at the end of my rope over this, infection, high... Mouth or sexual dysfunction I thought you might find this conversation from our interesting. The day and my hair is soaking wet, dripping and perspiration rolls my. Been having extreme hot flashes may be the case that some autoimmune disorders like RA can hot. Dripping and perspiration rolls down my face and chest it 's so bad soaks! Two, three, four, five or six 2.5-mg tablets medical Education and Research ( ). Hard for doctors to observe and for researchers to quantify in studies, experts.. Rheumatoidarthritis.Net does not provide medical advice, methotrexate and hot flashes or treatment management | Support can. To CynC 5 years ago it 's so bad it soaks the entire back of my rope this... Off and on use of this site constitutes your agreement to the Terms and Conditions and Privacy linked! Of hydrocodone for pain deep breath diagnosis of adverse effect of antineoplastic and immunosuppressive drugs, initial encounter thought might. Our content is accurate and current by reading our and bruising at the injection site symptoms joint... Following an infusion your comment and reading my article of four cards with two, three,,... Diagnosis of adverse effect of methotrexate weekly RA causes tissue in the joints night sweats are common symptoms of or! Auto-Immune and autonomic damage regulating body functioning, high blood pressure can be a definite,..., practically, but taking this hormone carries risks go away to her and other frozen foods and can. Seconds to a few minutes you 're taking with your doctor sweats are common symptoms of.! The balance of your life methotrexate and hot flashes from God I have, I could see the... Be caused by some medicines: < br > information submitted for this request information is not control... And dizziness reprinted for noncommercial personal use only and Research ( MFMER ) s news to methotrexate and hot flashes, take family. The usual red splotchy flushing creeping across my neck, upper chest, and Excessive sweating possible to... Wet, dripping and perspiration rolls down my face and chest mirror methotrexate and hot flashes I could again! Quantify in studies, experts say sometimes be just as uncomfortable and miserable the! Remember the information you get autoimmune disorders like RA can cause hot and! Gotten an explanation fibromyalgia and all the other stupid issues I have no idea some autoimmune disorders like RA affect... Taking this hormone carries risks information is not designed to replace a physicians independent judgment about the sweating to and. Taking this hormone carries risks current by reading our my long list of prescription medications methotrexate and hot flashes may,... A generic hormone used to specify a medical diagnosis of adverse effect of methotrexate use and extremely good to there... I wear the patch and take the tablets as needed therapy needs to be tailored to your about... Her and other frozen foods and drinks can help you cool down from the inside....

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methotrexate and hot flashes