Folic acid supplementation may cure hot flushes in postmenopausal women: a prospective cohort study

Background. Neurotransmitter norepinephrine seems to be involved in the pathophysiology of hot flushes in postmenopausal women, and folic acid was found to interact with its receptors.Objectives. To examine the effect of folic acid supplementation on the occurrence of hot flushes and the plasma level of 3-methoxy 4-hydroxy phenyl glycol (MHPG, the main metabolite of brain norepinephrine).Method. Forty-six postmenopausal women were allocated (by alternation) into 2 groups (n = 23 each); Group 1 received folic acid 5mg tablets daily for 4 weeks and group 2 received placebo tablets. Four women in group 2 discontinued the study.Results. The number of women who reported improvement in hot flushes was significantly higher in the treatment group. On comparing the mean plasma levels of MHPG before and after treatment, a significant lowering was found in the treatment group (mean % change =−24.1 ± 17.9, p < 0.001) when compared with the placebo-control group (mean % change =−5.59 ± 16.4, p = 0.10). In the treatment group, there was a significant negative correlation between improvement in hot flushes and the plasma level of MHPG (r =−0.453, p = 0.03).Conclusion. Folic acid supplementation may cause subjective improvement of hot flushes by lowering the increased central noradrenergic activity.