What Causes Hot Flashes and How to Treat Them?

It is not unusual for women to experience hot flashes either in the perimenopause or the post-menopause. In almost all cases, it is treated with some type of estrogen, preferably estradiol. However, very often this might provide a reduction in the severity of hot flashes, but does not cure the problem. The frequency and intensity of hot flashes vary among women and can last up to 10 years.

The best approach to dealing with any problem is to treat the cause of the issue. When it comes to hot flashes, one of the most common associated findings is the release of luteinizing hormone (LH) and follicular stimulating hormones (FSH) from the pituitary, that stimulate the reproductive system. The ovaries produce four different hormones – estradiol, progesterone, DHEA, and testosterone. A decrease in any of these hormones will result in the release of these two hormones.

It is unclear whether these two hormones actually cause hot flashes, but it is safe to assume that replacing some or all of the ovarian hormones might provide relief or elimination of hot flashes. This brings us to the connection between adrenaline and hot flashes. 

There is some thought regarding adrenaline being released in order to raise body temperatures due to the drop in body temperature due to a drop in estrogen.

A woman who experiences hot flashes around 2:30 - 3:00 am – the time that adrenaline levels are the highest – can very reliably accuse excess adrenaline as the cause of her hot flashes. This same woman might experience hot flashes during the day if she is under stress, if adrenaline is the culprit. 

In any event, perhaps a practical approach to hot flashes might start with a 5% progesterone cream, used 2-4 times a day with a dose at bedtime, DHEA 10 -25 mg depending on blood levels, and perhaps some estriol 2.5% and testosterone 2%. There is no one size fits all approach.

The Platt Wellness Center is unique in that Dr. Platt offers his guidance on nutrition, supplements and bioidentical creams to help facilitate healing using the innate power of the body to do so. He also directly answers questions sent to questions@plattwellness.com. All clients are advised to discuss his suggestions with their doctors and other health care practitioners.


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