Low Or Dropping Estrogen Levels
It is no surprise that hot flashes are most common in women entering peri- or menopause because thats when estrogen production starts dropping. However, it can occur earlier, before age 40, in those who are dealing with primary ovarian insufficiency. In this case, the ovaries arent working properly and cant release adequate estrogens and other hormones. This is another potential cause of low estrogen levels.
How do you know if you have low estrogen? Youll want to do a DUTCH hormone test to know for sure, but symptoms of low estrogen include:
- Loss of sex drive
- Irregular periods or no periods
What researchers are learning about estrogen is that its important to have a balance of estrogen-promoting and estrogen-limiting activities for us to have healthy hormone levels. Both estrogen dominance and low estrogen can be a problem, and thats where taking phytoestrogens from plants like flax and hops can help. Phytoestrogens can serve as weak estrogens that can help support low estrogen levels, yet replace more potent estrogens so that we dont become estrogen dominant.
While scientists dont know exactly why low estrogen levels can cause hot flashes, I believe that blood sugar imbalance and inflammation, when combined with dropping estrogen levels, is the perfect storm.
The good news is that there are food and supplements that can raise estrogen levels weve written a whole article about it.
Evidence For Combining Hormone Therapy And Radiation Treatment
Bolla M, Collette L, Blank L, et al. Long-Term Results with Immediate Androgen Suppression and External Irradiation in Patients with Locally Advanced Prostate Cancer : A Phase III Randomised Trial. Lancet 2002 360:1036. PMID: 12126818.
Bolla M, Gonzalez D, Warde P, et al. Improved Survival in Patients with Locally Advanced Prostate Cancer Treated with Radiotherapy and Goserelin. New England Journal of Medicine 1997 337:295300. PMID: 9233866.
DAmico AV, Schultz D, Loffredo M, et al. Biochemical Outcome Following External Beam Radiation Therapy With or Without Androgen Suppression Therapy for Clinically Localized Prostate Cancer. Journal of the American Medical Association 2000 284:12803. PMID: 10979115.
DAmico AV, Manola J, Loffredo M, et al. Six-Month Androgen Suppression Plus Radiation Therapy Versus Radiation Therapy Alone for Patients with Clinically Localized Prostate Cancer: A Randomized Controlled Trial. Journal of the American Medical Association 2004 292:8217. PMID: 15315996.
Denham JW, Steigler A, Lamb DS, et al. Short-Term Androgen Deprivation and Radiotherapy for Locally Advanced Prostate Cancer: Results from the Trans-Tasman Radiation Oncology Group 96.01 Randomised Controlled Trial. Lancet Oncology 2005 6:84150. PMID: 16257791.
Nesslinger NJ, Sahota RA, Stone B, et al. Standard Treatments Induce Antigen-Specific Immune Responses in Prostate Cancer. Clinical Cancer Research 2007 13:1493502. PMID: 17332294.
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Vaginal Dryness And Trouble Sleeping
In reality, menopause is normal, natural and inevitable. Perimenopause begins between ages 35 and 57, and menopause occurs around the age of 52 for most Canadian women .
Menopausal women cannot become pregnant and, beyond that, many are pleased to be free of unpredictable and sometimes flooding blood flow that one-third of women experience in perimenopause.
The night sweats and hot flashes that begin in perimenopause may last as long as 10 to 12 years. In general, menopausal women experience daytime sweating, which is less disruptive.
Menopausal women who dont have sex regularly will likely notice some vaginal dryness, some may have more trouble sleeping soundly and, for a few, a sudden urgency to pee may make it a race to get to the washroom on time.
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Intermittent Or Continuous Therapy
Once prescribed, hormone therapy used to continue for life, but scientists are now reevaluating that strategy and investigating whether hormone therapy can be taken intermittently, with so-called holidays from treatment. The thinking is that this may not only help restore quality of life as, for example, returning libido and sexual health but also delay the hormone resistance that eventually develops in men taking hormone therapy.
Clinical trials evaluating whether intermittent therapy is as effective or more effective than continuous therapy are now under way, so it is too early to say for sure.
Does Equelle Increase Estrogen Levels
Taking Equelle does not impact estrogen levels. Although Equelles active ingredient, S-equol, mimics some of the same activities of estrogen by preferentially binding to estrogen receptor beta, Equelle is a hormone free dietary supplement and clinical research shows S-equol supplementation reduces the frequency of hot flashes, supports the quality of sleep, reduces bothersome vaginal symptoms like irritation, soreness and itching, and alleviates mood swings.
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Using Hormones To Treat Hot Flashes And Night Sweats
Some women may choose to take hormones to treat their hot flashes or night sweats. A hormone is a chemical substance made by an organ like the thyroid gland or ovary. During the menopausal transition, the ovaries begin to work less effectively, and the production of hormones like estrogen and progesterone declines over time. It is believed that such changes cause hot flashes and other menopausal symptoms.
Hormone therapy steadies the levels of estrogen and progesterone in the body. It is a very effective treatment for hot flashes in women who are able to use it. They can also help with vaginal dryness, sleep, and maintaining bone density.
Hormone treatments can take the form of pills, patches, rings, implants, gels, or creams. Patches, which stick to the skin, may be best for women with cardiac risk factors, such as a family history of heart disease.
There are risks associated with taking hormones, including increased risk of heart attack, stroke, blood clots, breast cancer, gallbladder disease, and dementia. Women are encouraged to discuss the risks with their health care provider. The risks vary by a woman’s age and whether she has had a hysterectomy. Women who still have a uterus would take estrogen combined with progesterone or another therapy to protect the uterus. Progesterone is added to estrogen to protect the uterus against cancer, but it also seems to increase the risk of blood clots and stroke.
Progesterone For Hot Flashes: A Closer Look
Prior and her colleagues assigned 114 postmenopausal women who had hot flashes and night sweats to one of two groups. One group took 300 milligrams of Prometrium daily. The other took a placebo. Neither group knew whether they were taking Prometrium or the placebo.
The time since the last menstrual flow varied from one to 10 years and on average was four years. If the women had taken hormone therapy in the past, they had to have discontinued it for the past six months to be eligible to enter the study.
The women noted the number and intensity of symptoms in a daily diary, and then Prior calculated the average daily score that reflected the number and intensity of symptoms.
At the end of the 12-week study, Prior says, “Prometrium was significantly more effective than the placebo.”
The women taking Prometrium had a 56% decrease in their score, and the women taking the placebo had a 28% decrease.
The women taking Prometrium had a 48% decline in the number of symptoms women taking the placebo had a 22% decline.
None of the women reported any serious adverse events, Prior says.
Exactly how progesterone relieves the symptoms isn’t clear, Prior tells WebMD. “We know progesterone does lots of calming things in the brain. It may compensate for something estrogen does .”
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What Are Hot Flashes
Hot flashes are the most common and bothersome aspect of menopause. About 75 percent of women will experience them. They generally improve over time and resolve within a few years, but some women suffer for more than a decade. Frequent, severe hot flashes disrupt womens daily activities, work and sleep. Lack of sleep from night sweats can lead to fatigue, irritability and difficulty concentrating.
Some women do not need hormone therapy, Dr. Shifren says. Their hot flashes are mild and respond to lifestyle changes, like wearing light clothing and keeping the thermostat low, she explains.
Over-the-counter products containing soy or herbs decrease hot flashes although most of these products are no more effective than placebos. An anti-depressant-like drug is also approved for hot flashes, but it does not work as well as hormone therapy.
How Do I Treat A Hot Flash
Hot flashes may seem like an inevitable symptom of menopause that you just need to deal with. But there are treatment options to improve your hot flashes. If you have hot flashes, particularly hot flashes that disrupt your daily life, reach out to your healthcare provider to learn more about your treatment options.
In general, there are two categories of treatment options for hot flashes: prescription medications and over-the-counter therapies. Some prescription medications are used as off-label treatments to help reduce hot flashes. Using a product off label means that its not FDA-approved for the treatment of hot flashes, but is often used because it can be safe and effective as a treatment option.
Its important to talk to your healthcare provider about any treatment option and discuss the pros and cons. Your provider is aware of your medical history and other medications. Some treatment options may not be safe to take with your other medications or other medical conditions.
Prescription medications are typically considered to be more effective than over-the-counter treatments. These medications can include:
Hormone replacement therapy
Hormone replacement therapy boosts your hormone levels and can relieve some of the symptoms of menopause. Your provider will consider whether your uterus is in place or has been removed when prescribing hormone replacement therapy. Theyll prescribe:
Non-hormonal medications
Over-the-counter therapies
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Bothered By Hot Flashes Hormonal Optimization Can Help
Hot flashes can leave you drenched in sweat at any time of the day or night. Theyre a common symptom of menopause, with about 8 in 10 women experiencing them, but they dont just affect women in their 40s and 50s.
Hot flashes are a hallmark of menopause, but they can be a symptom of hormonal imbalance at any age. Other common causes of hormonal imbalance include giving birth and certain illnesses, but whatever the cause, hot flashes can severely limit your enjoyment of life.
At OB/GYN Specialists in Denton, Texas, Daniel McDonald, MD, , and our team are proud to offer hormone optimization services to help minimize hot flashes and other unpleasant symptoms of hormone imbalance. If youre bothered by hot flashes, its time to learn more about how hormone optimization could work for you.
Other Drugs Used For Menopausal Symptoms
Despite its risks, hormone therapy appears to be the most effective treatment for hot flashes. There are, however, nonhormonal treatments for hot flashes and other menopausal symptoms.
Antidepressants
The antidepressants known as selective serotonin-reuptake inhibitors are sometimes used for managing mood changes and hot flashes. A low-dose formulation of paroxetine is approved to treat moderate-to-severe hot flashes associated with menopause. Other SSRIs and similar antidepressant medicines are used “off-label” and may have some benefit too. They include fluoxetine , sertraline , venlafaxine , desvenlafaxine , paroxetine , and escitalopram .
Gabapentin
Several small studies have suggested that gabapentin , a drug used for seizures and nerve pain, may relieve hot flashes. This drug is sometimes prescribed “off-label” for treating hot flash symptoms. However, in 2013 the FDA decided against approving gabapentin for this indication because the drug demonstrated only modest benefit. Gabapentin may cause:
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Treating Hot Flashes Without Hormones
Review Shows Estrogen May Work Better Than Nonhormonal Therapies
May 2, 2006 — Some nonhormonal therapies may help treat hot flashes, but probably not as much as estrogen, doctors report in The Journal of the American Medical Association.
Those findings come from a review of 43 previously published studies. The reviewers included Heidi Nelson, MD, MPH, of Oregon Health & Science University.
Menopause isn’t a disease. But hot flashes are common and may be severe in menopausal women.
The studies in Nelson’s review tested these therapies to treat hot flashes:
- Antidepressants. Selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors such as Paxil, Prozac, Effexor, and Celexa
- Gabapentin . An antiseizure medication
- Red clover isoflavone extracts
- Soy isoflavone extracts
Each treatment was separately compared with a sham treatment . The women didn’t know whether they received the real treatment or placebo. They kept diaries of their hot flashes before and during treatment, which ranged in length from a few weeks to a year.
The Health Risks And Benefits Of Hrt
In 1991, the U.S. National Institutes of Health launched the Women’s Health Initiative , a set of studies involving healthy post-menopausal women that was carried out in 40 U.S. centres. The WHI included a clinical trial to evaluate the risks and benefits of the two types of HRT and to see how they affected the incidence of heart disease, breast cancer, colorectal cancer and fractures in post-menopausal women. The trial was divided into two arms:
- One arm involved more than 16,000 post-menopausal women aged 50 to 79 who had not had a hysterectomy. They took pills daily that were either a combination of estrogen and progestin , or a placebo .
- The second arm involved more than 10,000 women who had received a hysterectomy and who took estrogen pills alone or a placebo.
In July 2002, after an average 5.2 years of regular follow-up, the NIH prematurely ended the combined HRT arm of the WHI trial. An independent monitoring board, which regularly reviewed the findings, concluded that there were more risks than benefits among the group using combined HRT, compared with the placebo group. The study found that changes in the incidence of disease per 10,000 women on combined HRT in one year were:
- Seven more cases of coronary heart disease
- Eight more cases of strokes
- Eighteen more cases and a twofold greater rate of total blood clots in the lungs and legs
- Eight more cases of invasive breast cancer
- Six fewer cases of colorectal cancer
- Five fewer cases of hip fractures
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What Do Hot Flashes Feel Like
Hot flashes tend to come on suddenly and involve a number of distressing and uncomfortable symptoms:
- Sudden warmth of face, neck, and chest
Note that these triggers simply bring on a hot flash. They arent actual causes of the imbalance. I, therefore, looked deeper into what the underlying causes of hot flashes were. It turns out, there are at least seven, most of which you can control.
Buyer Beware: Unproven Nonscientific ‘treatments’ For Hot Flashes
You may have heard about black cohosh, DHEA, or soy isoflavones to treat hot flashes. These products are not proven to be effective, and some carry risks such as liver damage.
Phytoestrogens are estrogen-like substances found in some cereals, vegetables, and legumes , and herbs. They may work in the body like a weak form of estrogen, but they have not been consistently shown to be effective in research studies, and their long-term safety is unclear.
Always talk with your doctor before taking any herb or supplement. Currently, it is unknown whether these herbs or other “natural” products are helpful or safe to treat your hot flashes or other menopausal symptoms. The benefits and risks are still being studied.
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What Is Hormone Therapy
The idea that hormones have an effect on prostate cancer is not new. The scientist Charles Huggins first established this over 60 years ago in work that led to his winning the Nobel Prize. Huggins found that removing one of the main sources of male hormones from the body the testicles could slow the growth of the disease.
This procedure worked dramatically, says Holden, who is also director of the Prostate Cancer Center at Cedar Sinai Medical Center in Los Angeles. Before, these men were confined to bed and wracked with pain. Almost immediately afterwards, they improved.
Huggins found that some types of prostate cancer cells need certain male hormones called androgens to grow. Androgens are responsible for male sexual characteristics, like facial hair, increased muscle mass, and a deep voice. Testosterone is one kind of androgen. About 90% to 95% of all androgens are made in the testicles, while the rest are made in the adrenal glands located on top of the kidneys.
Estrogen And Hot Flashes: The Hormonal Link
Hot flashes are one of the most common symptoms associated with menopause, with up to four in five women experiencing hot flashes at some point in their lives – whether during perimenopause or menopause itself. If you’re experiencing them, you may be wondering about how they connect with the hormone estrogen responsible for most menopause problems. Learn about hot flashes, estrogen, and their connection.
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Can Hormone Therapy Cure My Prostate Cancer
No, hormone therapy cannot cure your prostate cancer. The goal of hormone therapy is to stop or slow the growth of the prostate cancer cells in your body. Hormone therapy can shrink prostate cancer tumors and may stop or limit the spread of your prostate cancer. Hormone therapy is used to control your prostate cancer.
Is It Possible To Cure Hot Flashes We May Be Getting Closer
Nearly all women suffer from hot flashes during menopause. Researchers have finally figured out what triggers thempaving the way for the first new class of treatments since 1941.
Most women experiencing menopause are all too familiar with hot flashesthe sudden onset of fast-rising heat, often accompanied by sweating, heart palpitations, dizziness, fatigue, and/or anxietythat are much more debilitating than their zippy name suggests.
Up to 80 percent of women report these flashes during menopause, a time when fluctuating and eventually plummeting levels of the hormone estrogen lead to the permanent cessation of menstruation and natural fertility. Hot flashes mimic how an overheating body cools itself, except this is an inappropriate activation because body temperature remains in the normal range, says Naomi Rance, a retired neuropathology professor at the University of Arizona College of Medicine and a pioneer in hot flashes research.
Scientists have long been puzzled about this symptom of menopausealso known as hot flushes and vasomotor symptomsbecause they didnt understand exactly what caused a woman to suddenly feel warm. But recently researchers identified a group of neurons in the brains hypothalamus responsible for triggering these flashes.
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