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HORMONES -
HOT FLASHES
Hot flashes are one of the most common symptoms of menopause and perimenopause. They can be caused by a deficiency of estrogen or progesterone. They can also be caused by a fluctuation of hormones and not necessarily by an absolute deficiency of estrogen. Hot flashes may be caused by other hormone imbalances including thyroid deficiency or excess, elevated cortisol, or high insulin levels. Hot flashes can be mild or debilitating.

Diet and lifestyle play a huge role in the onset and severity of hot flashes. Stress (elevated cortisol) is one of the most important contributing factors to hot flashes. Meditation and stress reduction can dramatically relieve hot flashes. Tension and anxiety can increase hot flashes. A regular exercise program is key to health, stress reduction, and hormone balance (including reduction of frequency and severity of hot flashes).

Diet is also critical to hormone balance. Lowering the refined carbohydrates in your diet will improve hormone balance and hot flashes. Soy foods can provide relief from hot flashes along with phytoestrogen products like Remifemin, Promensil, black cohosh, dong quai, and chaste berry.

Progesterone can alleviate hot flashes in approximately 80% of people. Estrogen, including estriol alone, is successful in about 90% of people. Sublingual estrogen or progesterone drops are rapidly absorbed and provide immediate relief. A low dose progesterone cream or estrogen cream applied behind the ears can also provide relief.

Occasionally high levels of stored progesterone or estrogen can accumulate with application to the skin. This can desensitize estrogen receptors and cause hot flashes. In this situation, one should reduce the dose of hormones and consider changing the application site to the mucous membranes where there will be no accumulation in fatty tissue.

Suggestions for Hot Flashes

1. Diet: Get the refined carbohydrates out of your diet. Eat whole foods, fruits, and vegetables.
2. Reduce Stress: Meditate, avoid stressful situations, and pay attention to how you react to stress. Practice deep breathing exercises throughout the day.
3. Herbal Products as mentioned above and Vitamin E 800 IU / day.
4. Low Dose Transdermal Progesterone Cream: Apply ½-1 gm daily or twice daily as directed. Consider application to the mucous membranes of the labia and vagina. You may want to apply a small amount behind the ears.
5. Sublingual Progesterone Drops: These are applied under the tongue and provide almost immediate relief. Hold under the tongue 3-5 minutes.
6. Lowering the dose of Transdermal Progesterone Cream or changing to mucous membrane application if accumulation is suspected.
7. Estrogen Cream or Sublingual Drops: Estrogen is always given in combination with progesterone. A bi-estrogen cream (estriol with estradiol) with progesterone may be applied to the mucous membranes of the labia and vagina or the skin (a small amount behind the ears will be absorbed rapidly).

You must play an active role in your medical care and health. KNOW your hormone levels. Have your hormone levels tested.

Sublingual drops have an almost immediate effect and can be dosed two to three times daily as need for relief of hot flashes.