Q. I’ve been taking estradiol Mondays, Wednesdays and Fridays for hot flashes for many years. (I used to take Premarin.)
My doctor asked me to stop the estrogen because she said she would get in trouble. Now I have hot flashes day and night. I am desperate. What else can I do?
A. We’re not quite sure why your doctor thinks she would get into trouble for prescribing estradiol for hot flashes. Although estrogen has the potential to increase the risk for blood clots, high blood pressure, migraines and breast cancer, it is the most effective way to control menopausal symptoms. Stopping estrogen suddenly can trigger rebound hot flashes (Maturitas, Aug, 1983).
One alternative is Pycnogenol. This compound is derived from the bark of French maritime pine trees and is rich in procyanidins. A randomized placebo-controlled trial found that Pycnogenol was especially helpful for hot flashes and sleep problems associated with menopause (Journal of Reproductive Medicine, Feb, 2013).
We are sending you our Guide to Menopause, in which we discuss the pros and cons of hormones as well as many alternatives including details on Pycnogenol, black cohosh and progesterone.