More than 500,000 women in the United States take tamoxifen. It is the oldest and most prescribed treatment for breast cancer and can reduce the risk of a woman developing breast cancer again by about 50 percent. However, tamoxifen causes side effects, especially hot flashes, which may become very uncomfortable.

Tamoxifen works by blocking the effects of estrogen in breast tissue. Physicians often prescribe it following surgery for early stage, hormone-receptor positive breast cancer. They also use it to treat men and women with advanced breast cancer to slow the progression of the disease, and for women who don't have breast cancer but are at high risk for developing it.

About 30 percent of women taking tamoxifen also take antidepressants called SSRIs (selective serotonin reuptake inhibitors) to treat depression and hot flashes. You may be familiar with the brand names of these popular medications: Prozac, Paxil and Zoloft.

Although the studies so far yield inconsistent results, in the most recent study of women taking tamoxifen, results indicated that using antidepressants increased the risk of breast cancer recurrence by more than 50 percent. In an interesting and hopeful study reported in October 2008, researchers found that hot flashes, night sweats and joint symptoms in breast cancer patients taking tamoxifen might signal a reduced likelihood of cancer recurrence.

These studies also raise concerns that antidepressants may also interfere in the effectiveness of tamoxifen. If you are taking tamoxifen for breast cancer, you may want to consider alternative methods to ease your hot flashes. Exercise and calcium help reduce hot flashes for some women. If these are not effective for you, ask your physician about medications such as Clonidine or Megace. Some physicians recommend women on tamoxifen take periodic breaks from the medication as another way to provide some relief from hot flashes.

Here are a few other tried-and-true techniques for alleviating hot flashes.

  • Avoid spicy foods, hot drinks and caffeine
  • Practice stress management techniques such as meditation and slow abdominal breathing
  • Acupuncture
  • Soy foods
  • Vitamin E (800mg)
  • Black cohosh (an herb)