Hot flushes, tamoxifen and many different views

Hi all, 

I am 3 months into tamoxifen post lumpectomy, chemo and radiotherapy.  and also had to have a hysterectomy a month ago my main problem is sleep disturbance and hot flushes as I have the double whammy of tamoxifen and no overies.

i saw my oncologist last week who approved me taking 5htp for the sleep disturbance ( it increases uptake of seratonin and melatonin ) and she also suggested evening primrose oil and acupuncture.

in researching these I came across lots of recommendations for taking sage as a supplement for the hot flushes. Looking at all the posts there seems to be a huge range of conflicting info so I had a look on the NATIONAL INSTITUTE OF CLINICAL EXCELLENCE website which makes the following recommendations 

Menopausal symptoms

1.13.8 Discontinue hormone replacement therapy (HRT) in women who are diagnosed with breast cancer.
1.13.9 Do not offer HRT (including oestrogen/progestogen combination) routinely to women with menopausal symptoms and a history of breast cancer. HRT[13] may, in exceptional cases, be offered to women with severe menopausal symptoms and with whom the associated risks have been discussed.
1.13.10 Offer information and counselling for all women about the possibility of early menopause and menopausal symptoms associated with breast cancer treatment.
1.13.11 Tibolone or progestogens are not recommended for women with menopausal symptoms who have breast cancer.
1.13.12 The selective serotonin re-uptake inhibitor antidepressants paroxetine[14] and fluoxetine[14] may be offered to women with breast cancer for relieving menopausal symptoms, particularly hot flushes, but not to those taking tamoxifen.
1.13.13 Clonidine, venlafaxine[14] and gabapentin[14] should only be offered to treat hot flushes in women with breast cancer after they have been fully informed of the significant side effects.
1.13.14 Soy (isoflavone), red clover, black cohosh, vitamin E and magnetic devices are not recommended for the treatment of menopausal symptoms in women with breast cancer.


as you see they clearly state that we should avoid soy, red clover, black cohosh, and vitamin e and magnetic devices so am I wrong to chance taking the sage ? 

Hi Cath50, 

I am sure some of our users will be along soon to offer their support and share their stories. 

We do have a booklet on Menopausal symptoms and breast cancer which you can download or order and that you may find useful.  

In the meantime you could always call our helpline who can talk you through some of the questions you have on what to avoid. You can contact them on 0808 800 6000. The opening hours are below.

Monday-Friday, 9am-5pm
Late opening Monday and Wednesday 5pm-7pm,
Saturday, 9am-1pm 

Best wishes, 


Cath50 I know it’s a month since your post, but just in case you do check this thread again, my sister lives in Germany & their GPs all recommend sage tea & there is research to suggest it can reduce flushes by 64%, along with avoiding hot drinks & alcohol.  You can still have hot drinks, just let them cool a bit before you drink them, which is ok for green & camomile teas.  Not sure if I would fancy a lukewarm coffee much though. Re alcohol, I get an immediate flush if I drink a glass of wine & wake up really hot in the night, which I don’t do normally. x

Thanks for your posting of the NICE guidelines - very helpful.  As you say, they detail things we should avoid, however sage isn’t on that list, so I would think it is OK to try to see if it helps you.  If it does, please let us know! :slight_smile:

Never thought about buying it. Just put 5 leaves in hot water & leave for 10-15 mins. Doesn’t taste of much & weirdly gets rid of sore throats too.  Found out the latter last week.x

I read this about …Sage is known for its minty flavor and pungent aroma but turns out it can pack in a punch against cancer. This herb has been found to induce cell death and reduce growth in melanoma cells, colon carcinoma cells, and hepatoma cells.4Sage basically has many bioactive compounds with beneficial effects. Ursolic acid, a compound present in it, has been found to be particularly effective at fighting cancer so many mixed answers it’s too confusing and worrying

Hi Cath50,


My oncologist suggested I try sage and evening primrose oil for really bad hot flushes. I found taking a fairly high dose of sage, taken twice a day, dramatically reduced the hot flushes for about 12-18 months, then the effect wore off. So I went cold turkey on sage (in a manner of roast dinner speak) hoping that if I had a gap, my body might readjust and it might work better again. So tried evening primrose oil, which I think may help a little bit, and after a long break from sage now take a lower dose just once a day, which helps a fair amount, though I still have disturbed sleep due to flushes.


From what I can gather on the forum, sage works for some people but not for all.


As a cautionary note, someone once replied to one of my posts recommending sage for hot flushes, saying It might affect blood pressure in some people. So, anyone thinking of taking sage might want to read about that, before they try sage.



It’s possible that soy advice is out of date. For example, studies have shown women who consume the most soy foods (e.g. Japanese women) have lower rates of breast cancer. Try googling “Soy Phytoestrogens for Menopause Hot Flashes”. You may also want to research ground flaxseed (due to the the lignans). Of course, the results seem to be mixed so may not work for you.


Some even use essential oils to help, e.g. clary sage, but reports seem to be anecdotal only.