Hot Flashes are embarrassing.
This weekend I went to our neighbors’ son graduation party. As soon as I walked into the door, I was greeted by our neighbor cousin. She introduced herself as Suzie.
It was obvious that I had missed the early party. Wine had definitely been served.
She explained how she was from Los Angeles and she worked in the public relations business.
I explained to her that Vicky and I had a daughter living in Hollywood and that she was in the fashion business. Vanessa, our daughter, had known since she was very young that she wanted to be a fashionista.
Being a proud parent and the need to strike a conversation with this new acquaintance, Vanessa was the ideal conversation starter.
I was explaining how Vanessa represented high-end fashion lines and that her job was to sell these lines to high-end department stores.
As I was being a proud father, I noticed that I had lost Suzie’s attention. It wasn’t because of the conversation.
Suzie’s face, neck and chest had turned red and had become blotchy.
She looked for a split second as if she was going to faint. She started fanning herself.
Me, specializing in hormone optimization for the last 10 years of my practice, knew what she was experiencing.
Listening to hundreds, maybe even thousands, of my past patients and current clients, I knew that she was experiencing an unannounced feeling of intense heat that was making her face, neck and chest feel hot.
As I smirked a bit and looked at the wine she was drinking, she grabbed my shirt sleeve and held on.
Of course, Vicky was coming through the door at that exact moment.
Suzie was still fanning herself.
Vicky being the wittiest person I know, said:
“I totally understand. I get all hot TOO when I’m standing that close to MY HUSBAND.”
She might not have said my husband in an uppercase tone, but I definitely felt an uppercase tone.
Suzie explained that she has been having hot flashes quite regularly and they were chronic. Meaning that she had been having them for years.
She had seen me look at her wine earlier, and she explained that her hot flashes were worse when she was drinking wine.
Joe, our cohost and father of the graduate, walked up and said something about me meeting his free spirited cousin.
Suzie quickly explained that she was having a hot flash and Joe quickly explained that I was once a hormone doctor.
Suzie asked me what caused a hot flash and I explained hormones obviously, but that we are not really sure why.
For some reason the blood vessels near the skin dilate.
Suzie went on to say that she had them for way too long. She went on to ask me what she she should do. She also had said that she had taken estrogen, but that she was scared away from it because her mother had breast cancer.
I explained that hot flashes are not always menopausal, but most the time they were. I explained that even if it wasn’t caused my menopause, they are nearly always caused by a hormonal imbalance.
Many of the other causes of hot flashes such as atrophic vaginitis and dysfunctional uterine bleeding were also hormonally induced.
“SO WHAT DO I DO DOC?” Suzie asked with an air of desperation.
There are 3 sets of hormones involved with hot flashes. The first set, and the hormones that are usually the culprits, are two of the three sex hormones.
These two hormones are called progesterone and estradiol. Estradiol is one of the three estrogens. These two hormones become out of balance, especially after menopause or if you have excess abdominal fat.
“Abdominal fat?” Suzie asked as she sucked in her belly and patted it.
When a woman goes into menopause, her fat burning hormones reduce drastically and she starts to store fat in her belly area. There are enzymes in these fat cells that convert progesterone and testosterone into estradiol.
Fat makes estradiol, estradiol makes fat, fat makes estradiol.
The more abdominal fat you have the more out of balance your hormones will be.
“SO WHAT DO I DO DOC?” She asked again.
If you were my wife, I would have you test your progesterone to estradiol ratio. We call this your P/E ratio.
The minimum P/E ratio should be 200 to 1, meaning you should have a minimum of 200 molecules of progesterone to every one molecule of estradiol.
Once she got her P/E ratio back, I would have her supplement with low dose hormone creams.
“Which ones?” Suzie asked.
It would depend on what her P/E test indicated. Ninety-eight times out of a hundred, menopausal women have a low P/E ratio.
The first time I tested my wife, about a decade ago, she had a 36 P/E ratio. She was very estrogen dominant.
She added some progesterone cream and Wa La, no more hot flashes.
(Her P/E ratio was 400 that last time we tested and she has made menopause awesome.)
“I thought low estrogen was what caused hot flashes.” Suzie asked.
It is, but when you are menopausal, you lose between 40 to 60 percent of your estrogen levels and 80 to 90 percent of your progesterone levels.
It’s not the levels of your hormones, it’s the balance between the them.
You lose nearly all of your progesterone production when you develop menstrual irregularities in perimenopause and when menstruation completely stops in full blown menopause.
“So how can I get the tests and where do I get the cream if I do need progesterone. And what happens if I fall in the 2%, which would not surprise me.” Suzie asked.
Again if you were my wife and she fell in that 2%, that would mean that she needed estrogen. I would have her get a combination of two estrogens called estriol and estradiol. It’s called biest.
“So, I would need a prescription for the tests and the creams?” Suzie asked.
Send me an email and I will send you a link for the test that my wife uses.
Prescriptions are no longer needed for the tests or the hormone creams.
Before you use any hormone creams, you will need to speak to your physician.
“Yeah, sure, my doctor won’t even talk to me about hormones.”
These are just the first 2 steps. When you are in menopause, there are a minimum of 72 steps you will need to take to MAKE MENOPAUSE AWESOME.
When It Comes To Hot Flashes:
The problem was not how low my wife’s estrogen levels were, but how out of balance her progesterone and estradiol were.
The solution was correcting her balance between progesterone and estradiol.
“What happens if my, what did you call it, ratio?”
“P/E ratio.” I answered.
“What if it is normal? What do I do then?”
There are several other steps associated with her sex hormones that I would have her do first.
I would have her optimize her systemic inflammation and also have her optimize her liver.
Then, I would have her optimize her thyroid. And if that didn’t work I would have her optimize her adrenals.
80% of the time, in my experience, the hot flashes are caused by an imbalance in the sex hormones. 15% of the time it is a combination of the sex hormones and thyroid hormones. And 5% of the time it is a combination of the sex hormones, thyroid hormones and adrenal hormones.
If you are interested in testing your P/E ratio, email us your request and write, “Hey, I want the link for the P/E ratio Test.”
We will send the link to where you can purchase it and test yourself in the convenience of your own home at a fraction of the cost that we charged in our medical clinics, and without the need of a prescription or req form. This is the same lab company and test kits we used in our medical clinics.
Making Menopause Awesome
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