What's the BEST way to stop hot flashes and other menopause symptoms

Hot flashes, night sweats, vaginal dryness, painful intercourse

Obviously, I've never experienced menopause symptoms, but I've talked to over 2000 women who have. It sounds absolutely miserable. Some of the women I've talked with have told me heartbreaking stories of how menopause has quite literally ruined their lives.

A good friend recently reached out to ask me what she should do about hot flashes specifically, along with not sleeping well and all those other life-changing menopause symptoms.

In a recent video, I talked about how hot flashes are probably the best thing that can happen to a woman in menopause.

The reason I say that isn't because I'm an insensitive, misogynistic, mansplaining jerk. It's that I see lots of women without menopause symptoms who SEEM to sail through menopause without a care. It's those women who end up with some really serious health risks, which I'll talk about.

Hot flashes are a powerful warning sign that something's wrong. They motivate women to make a change.

How To Stop Hot Flashes? (It's Estradiol!)

How to stop hot flashes? The most effective treatment is optimizing your estradiol.

Estradiol is the most powerful and most important estrogen, made by your ovaries.

At least your ovaries make estradiol up until about age 51. After that time, they're genetically programmed to completely stop making it. And that's the real reason, the root problem, that causes you to have hot flashes and a bunch of other menopause symptoms.

The loss of estradiol is THE reason for a whole bunch of your menopause symptoms:

  • hot flashes
  • night sweats
  • weight gain
  • vaginal dryness and itching
  • irritability
  • anger
  • mood swings
  • painful intimacy
  • confusion
  • brain fog
  • itchy, dry skin
  • urinary incontinence

Other menopause symptoms like insomnia, depression, and anxiety that are caused by the loss of different hormones. I'll talk about those in another post.

As I've already alluded to, the loss of estradiol at menopause also puts you at serious risk for a bunch of long-term health issues. Things like:

  • your insulin doesn't work like it used to and you get insulin resistance
  • insulin resistance can lead to type 2 diabetes
  • your bones get hollow and weak and you can eventually get osteoporosis
  • osteoporosis might land you in a rehab hospital or even a nursing home after a broken hip
  • low estradiol makes it more likely you're going to develop Alzheimer's
  • estradiol that's low for years makes you MUCH more likely to get heart disease

I have a whole different video about heart disease. It's the #1 killer of women over 50 - after 50. Heart disease kills 10 times the number of women as breast cancer does. 

Optimal Estradiol

Getting your levels of estradiol just right - not too high and not too low - is the key to eliminating a long list of menopause symptoms. In addition to eliminating symptoms, optimal estradiol is also a key, along with diet, exercise, and optimizing some other crucial hormones, to long-term health and wellness.

Stop Hot Flashes and Other Menopause Symptoms

Oral or transdermal estradiol taken for whole body (systemic) effects

  • relieves hot flashes and night sweats
  • helps with weight gain
  • reduces mood swings and irritability
  • settles down heart palpitations

Estradiol in a vaginal cream form, either applied externally to the labia or inserted into the vagina

  • relieves vaginal itching and dryness
  • removes pain from intimacy
  • reduces mood swings and irritability
  • helps with urinary incontinence

Estradiol Side Effects

The most common side effect of estradiol is breast tenderness. That's almost always a dosage issue. If your estradiol dose is too high, you'll have tenderness. If your dose is too low, you'll have hot flashes.

There are some women who are at risk for blood clots. If you've had a serious blood clot, especially in your legs or your lungs, some providers recommend a transdermal estradiol patch or estradiol cream, rather than an oral estradiol tablet or capsule, sometimes called "estradiol pills." A provider who knows what they're doing will know how to handle that.

Estradiol - Prescription Only

That means you'll need a licensed healthcare provider to get estradiol. You can't take an herbal supplement or change your diet or exercise in order to increase your estradiol.

No matter how many people say you can "balance your hormones naturally," you simply cannot reverse the genetic programming of your ovaries and make them start manufacturing estradiol after you've gone into menopause. If you have valid, scientific proof that I'm wrong about that, I'd love to take a look at it.

That's not to say you have absolutely ZERO estradiol after menopause.

Your uterus and fat cells also make some estradiol. But the amount is really negligible compared to what your ovaries USED TO make.

Estradiol Should Be Given With Oral Progesterone

I'll talk about progesterone in another post.

What you need to know right now is that estradiol should always be given along with progesterone. That holds true whether you have a uterus or not.

Some providers assume you don't need progesterone if you don't have a uterus but that's an old way of thinking that doesn't take into account all the evidence. It also treats only SOME of your menopause symptoms and leaves you hanging when it comes to sleep, depression, and anxiety.

Not Every Provider Is Comfortable Prescribing Estradiol

My friend Stacy, who contacted me recently, said that a nurse practitioner she saw took her off of estradiol.

Unfortunately, that's extremely common.

The conventional wisdom says: "Hormones cause breast cancer," "They increase heart attacks in women," and "Hormone replacement therapy should only be given for 5 years after menopause"

The basis for those ideas is mainly a big study called The Women's Health Initiative. The WHI influences a LOT of doctors who've never really looked closely at it, but who live by that conventional wisdom.

Evidence Contradicts Conventional Wisdom About Estradiol

There's overwhelming evidence that estradiol:

  • doesn't "cause" breast cancer - although it may have an influence on breast cancer
  • won't increase heart attacks in women and probably even prevents them - as long as it's given early in menopause, before heart disease has a chance to take hold
  • helps prevent long-term health risks and should be maintained at optimal levels for the rest of your life

People in general tend to hold onto what they believe is true and deny any new evidence to the contrary. That's exactly what happens with doctors who haven't really evaluated all the evidence about estradiol.

2 Ways Way To Get Estradiol Optimized

  1. You can ask a doctor you're thinking of going to about their view on hormones. If they seem open minded and maybe familiar with the evidence about estradiol - go for it. If they're hesitant or only seem to know the "conventional wisdom," based on the Women's Health Initiative, proceed with caution.
  2. You can look for a hormone optimization specialist - a provider who has experience and expertise in menopause and in optimizing hormones for men and women over 50. I work with hundreds of them and might be able to give you some recommendations. No guarantees, mind you, but I can take a look.

If you're interested in finding a hormone specialist in your area - somebody who knows about how to stop hot flashes by optimizing your estradiol, click the link that says "Find help with your hormones" and I'll get your name, your city, and your ZIP code, along with your email address. I'll let you know if there's a specialist close to you.

I'll also be sending you some emails about hormones and menopause you'll find helpful.

Take a look at my other video about Estradiol and heart disease.

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About the Author

I'm here to help with easy-to-understand patient education resources for both patients and healthcare practitioners. I save providers time in getting patients up to speed. I also love matching patients who need help with experienced hormone optimization practitioners.

  • Hi Steve!!! Well I’m 50!!! And def suffering some pre menopause stuff. Lad said contact you..so I looked you up and I’m reaching out. Any trusted colleagues in Cleveland area? Hope you and Mary are thriving and doing amazing!! Much love, Crystal Chapman!!

    • Hey Crystal! Great to hear from you.

      I’ll have to take your word for it about being 50, even though that’s a bit far-fetched.

      I’ll take a look at my provider database to see who I might know near you. In the mean time, I’d love it if you could fill out my referral request form. I’m always nervous that I’ll drop the ball on some of them, since I get a lot.

      We’re doing well, back in Salt Lake after a couple years in the NW. Talk with you soon.

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    Patients: Find help with your hormones

    I have relationships with hundreds of hormone optimization specialists, all over the US and some in other countries. I can't guarantee that I know providers in your area, but I'll give it my best shot . . .

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