When estrogen as estradiol is used transdermally as a patch, gel, or pessary with micronized progesterone this may avoid the serious side effects associated with oral estradiol HRT since this avoids first pass metabolism ( Phase I drug metabolism). [21] Women taking bioidentical estrogen, orally or transdermally, who have a uterus must still take a progestin or micronized progesterone to lower the risk of endometrial cancer. A French study of 80,391 postmenopausal women followed for several years concluded that estrogen in combination with micronized progesterone is not associated with an increased risk of breast cancer. [22] The natural, plant-derived progesterone creams sold over the counter contain too little progesterone to be effective. Wild yam ( Dioscorea villosa) extract creams are not effective since the natural progesterone present in the extract is not bioavailable. [23] Selective serotonin reuptake inhibitors [ edit ] Blood vessels near the surface of your skin widen (dilate) to release heat. This creates the red flush you see on your skin. There’s nothing you can do to avoid hot flashes around menopause. But you can stay away from triggers that may make them more frequent or more severe. Common ones include: Researchers do not know exactly what causes hot flashes. Current theories suggest hot flashes are due to a menopause-related drop in the body's level of female hormones called estrogens. This drop affects the hypothalamus, an area of the brain that regulates body temperature. Hot flashes are the most common symptom of menopause and perimenopause called vasomotor symptoms (VMS). More than two-thirds of North American women who are heading into menopause have hot flashes. They also affect women who start menopause after chemotherapy or surgery to remove their ovaries. What Is a Hot Flash?

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https://www.menopause.org/for-women/expert-answers-to-frequently-asked-questions-about-menopause/hot-flash-faqs-triggers-symptoms-treatments Santen RJ, Allred DC, Ardoin SP, Archer DF, Boyd N, Braunstein GD, etal. (July 2010). "Postmenopausal hormone therapy: an Endocrine Society scientific statement". The Journal of Clinical Endocrinology and Metabolism. 95 (7 Suppl 1): s1–s66. doi: 10.1210/jc.2009-2509. PMC 6287288. PMID 20566620.Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

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Hot flashes affect about 85% of women during the years immediately before and after menopause. Menopause usually occurs around age 51, but hot flashes can begin as early as 2 to 3 years before the last menstrual period. There is some evidence that women who go through menopause due to surgery may have more severe hot flashes for more years than women who go through natural menopause. PreventionThe U.S. Food and Drug Administration (FDA) has approved the use of paroxetine, a selective serotonin reuptake inhibitor (SSRI) antidepressant, to treat hot flashes. Researchers are studying other antidepressants, which doctors may prescribe for off-label use. Explore mind-body practices. Some early-stage research has shown that hypnotherapy and mindfulness meditation could help with management of hot flashes. Women who experience troublesome hot flashes are advised by some to try alternatives to hormonal therapies as the first line of treatment. If a woman chooses hormones, they suggest she take the lowest dose that alleviates her symptoms for as short a time as possible. [19] The US Endocrine Society concluded that women taking hormone replacement therapy for 5 years or more experienced overall benefits in their symptoms including relief of hot flashes and symptoms of urogenital atrophy and prevention of fractures and diabetes. [20] Menopause is the main cause of hot flashes. During this transition, levels of the hormone estrogen fall. This drop in estrogen throws off your body’s “thermostat” — a gland called the hypothalamus at the base of your brain that regulates your internal temperature.