Bioidentical Progesterone and Hot Flashes

Hot flashes usually begin when periods are still regular or are just starting to fluctuate. Hot flashes are often one of the first indications that menopause is approaching. Hot flashes are most uncomfortable in the first stages of perimenopause, gradually decreasing in frequency and intensity as the body adapts to the hormonal changes. 

Duration, frequency, and intensity of hot flashes differ. Episodes may last for two to three minutes or they can also linger for up to an hour. They can occur several times a day or night, or only once or twice a week. 

As harmless as the hot flash is, nevertheless the body’s temperature control system vacillates between very hot and cool, other body systems are strained as well. When flashes occur too often they may be accompanied by unexpected and even frightening side effects: loss of sleep, fatigue, weakness, dizziness, a racing pulse, heart palpitations, headaches, itchy skin, and numbness in the hands and arms. These symptoms can take you unaware and cause concern as thoughts of more serious causes race through your mind. 

Hot flashes are not a sign of estrogen deficiency, per se, but are due to heightened hypothalamic activity (vasomotor lability) secondary to low levels of estrogen and progesterone which, if raised, would produce a negative feedback effect to the pituitary and hypothalamus. Estrogen receptors in these areas become more sensitive, and hot flashes usually subside, once progesterone levels are raised. Measuring FSH and LH levels before and after adequate progesterone supplementation, will validate this mechanism.