Hot flashes in a menopausal woman comes from the aging ovaries inability to ovulate any longer and finally the shortage of eggs and withdrawal of and then chronically low levels of estrogen, progesterone, and testosterone.
Mostly hot flashes occur in women transitioning through menopause, but women who have low estrogen and testosterone for other hormone imbalance reasons can have hot flashes as well.
Many women will have only months to just a few years of significant hot flashes, but we know they occur over many years for some women, and the average is much longer than the 5 years we used to assume they occur.
Hot flashes can be eliminated by appropriate natural bioidentical hormone therapy. Although not a 100% of women will respond with a complete treatment response and never have hot flashes (maybe 98% will!). Most all women will respond with enough effect to be satisfied. Using modest and low dose hormone therapy makes it take awhile to treat.
For some estrogen and progesterone alone doesn’t work and we consider using BioTE testosterone pellets for the right individuals.
It is possible to successfully treat mild to moderate hot flashes with non-hormonal methods as well, and there are many, but few treatments replace the gold standard of menopausal therapy which is estrogen treatment.
Hot flashes should not cause menopausal bleeding, sexual problems, nor pelvic pains, all of which need to be evaluated separately.
Because the hot flashes are caused by surges in brain chemistry triggered by the low hormones, medications that affect those receptors can treat this as well. We have recently discovered low levels of antidepressant medication can work, and the medication Brisdelle is one example of a non-hormonal way to treat hot flashes. There are new prescription non-hormonal medication’s coming as well.
Being fit and eating correctly is important for management of all life stages but one of the largest hot flash studies unfortunately showed that exercise, although very health beneficial, doesn’t treat hot flashes. Nor did yoga in this study actually treat hot flashes, but the patients did sleep better, in spite of residual hot flashes, when they participated in yoga.
The most popular oral therapy to date has been using conjugated equine estrogens, and this has lately been replaced by bioidentical estradiol or bioidentical combination therapies, such as bioidentical testosterone administered by pellet implants most all of which are effective in the management of vasomotor symptoms of menopause.
Some women have to be managed with combination therapies. In an analysis of data from the Women’s Health Initiative (WHI) study use of estrogen therapy was associated with a 28% relative improvement in the relief of hot flashes compared with placebo and placebo cures hot flashes in about 20-30% of cases, although some women get literally 100% treatment success.
You want to make sure all your menopausal conditions are being successfully treated.. The key to successful therapy has been managing side effects and risk of all menopausal therapy. And for women with osteoporosis making sure they have appropriate dosing and medication to treat their bones, and women who have sexual complaints may need other management as well. For many women with atrophy the systemic estrogen and testosterone can be enough to treat vaginal atrophy as well, for many women they need direct vaginal treatment.
For women who do not want direct vaginal estrogen treatment they may want to consider Co2 resurfacing of the vaginal tissues with the painless MonaLisa Touch therapy or Radiofrequency ThermiVa treatment . This can be done by using lower dosing, dosing through the skin with either a patch or a topical application, and minimizing progesterone exposure.
Bioidentical progesterone is usually given just to protest the uterus from estrogen.
Other places to menopausal research include: the National Institute on Aging the National Institute on Complementary Medicine or the Office of Women’s Health Research.
