Lots of questions have come up in response to my video about Estrogen Dominance.  First of all, let’s bust a myth that hot flashes mean someone necessarily has overall low estrogen levels. Not true!  In fact, research does not generally show a correlation between circulating estrogen levels and the incidence (or severity) of hot flashes.

Surprised?  Most people are.  A hot flash is triggered by the hypothalamus in the brain and occurs to release heat that has built up in the body in response to a surge of norepinephrine and/or epinephrine (catecholamines or “stress hormones” – what we typically call “adrenaline”).

In fact, a woman can indeed be estrogen dominant (and even have relatively high levels of estrogen) and still wrestle with hot flashes.  It is a sudden drop in estrogen (meaning a higher level of variation) that can trigger the cascade that causes a hot flash.  But it’s more complex than than…  High cortisol, low cortisol, low progesterone, or low serotonin can all be drivers for hot flashes!    This is such a fascinating topic; I could go on and on…  Clinical study shows that not hot flash remedy works for everyone but here are a few biohacks to help support and balance your happy hormones (e.g.  )


My favorite combination that seems to get excellent results for nearly all late  perimenopausal women with persistent (day and night) hot flashes includes:

  • 2 Tbsp ground flaxseed daily
  • Black cohosh and Vitex twice daily
  • Caffeine reduction (check out mt blog on bulletproof coffee)
  • Lower alcohol.  Elimination of wine (especially red wine!)  Sorry, but that wine night habit with your girlfriends is not helping your hormones
  • Dedicated help with Stress Relief and stress management habits (and why I LOVE to teach mindfulness & meditation)
  • And if you need more oomph –  perhaps maca root powder (This is the key item for some – myself included!  Start slowly though (e.g 1/2 tsp).  It’s highly stimulatory to some, while others need much more (e.g. 1-2 Tbsp)).

Chronic stress often causes HPATG axis imbalance or dysregulation which can deplete progesterone (aka “The Cortisol Steal”) and cause imbalance in estrogen receptor sensitivity.  In my clients, well over half of women with rough hot flash experiences get tested and find they have low progesterone.  Not a surprise since the ovaries begin to make less and less progesterone 5+ years prior to menopause, and drop more dramatically and sooner than estrogen does.  What the ovaries stop making, the adrenal gland has to pick up.  And it may or may not do that effectively given the other stressors at play!

For people of all ages who wake up with a “hot flash” type of experience in the 2-4 am timeframe (and really only struggle with the flashes at night), I find a surge of cortisol is usually the culprit.  Taking calming adaptogenic herbs at night before bed can help (e.g. holy basil, ashwaghanda) as well as extracts that help to calm the action of adrenaline (e.g. magnolia, l-theanine).  One of my favorite remedies for this is Xymogen’s CortiSolv.

Need more help getting your balance back on track, connect with me for an initial consultation!

Wishing you happy hormones and cool nights!