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why am I having hot flashes starting again five years after a total hyst?

By February 8, 2009 - 10:22am
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I had a complete hysterectomy five years ago (at age 45) to remove a large fibroid tumor and (hopefully) end my long struggle with PMS. It worked! I immediately went on estrogen-alone therapy. I gradually tapered down to .5 mg (higher doses made me feel PMSy, lower doses left me with hot flashes). I've been at this dose ever since, feeling much much happier than I ever did in my reproductive years. The only drawback has been diminished libido and vaginal dryness.

In just the last few weeks I started having frequent hot flashes and headaches that remind me of the kind I got with PMS. Is this normal? Everything has been so stable hormonally over the past five years that I worry that this onset of symptoms means something sinister. I did switch to a vegan diet about three months ago. Could that have an effect on my hormonal profile?

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HERWriter Guide

Hi cyneller

Thank you for your update. While obviously we have no definitive answer to your issue (you'll get that from your doctor), I think you really need to check into the diet factor and if that's the problem (which would be great!) then either an adjustment in your estrogen dose may help - or some diet modifications.

Best of luck to you!

February 11, 2009 - 12:29pm

Thanks so much. I think it is probably dietary, since I am avoiding soy (I'm allergic to it). I can't go back to eating meat and dairy, so I'll see about increasing my estrogen dose a bit.

When I talk to my doctor about my estrogen dose, I'll ask about the possibility of hypopituitarism. I know that during my reproductive years, all my hormone levels were quite low, to the point that the doctors and nurses treating me for PMS believed that I could not be ovulating (which turned out not to be the case, since I got pregnant twice, practically when I just thought about having unprotected sex!). So maybe that is a factor.

Again, thanks so much, you really set my mind at ease.

February 9, 2009 - 3:41pm
HERWriter Guide


Thanks so much for your question.

It's important to remember, firstly, that women react differently to hysterectomies.

Hot flashes are caused by a change in estrogen levels so your estrogen levels may have changed in the last month. In your case, they might have lowered (as you mentioned, it's the lower levels of estrogen that often cause hot flashes/menopausal symptoms).

Since you had a complete hysterectomy, I'm wondering if you have a hypopituitarism. The pituitary gland has several functions and one of them it that it releases a luteinizing hormone- and this is the hormone responsible for testosterone production and regulation in men the production of estrogen in women.

Hypopituitarism means the pituitary gland is not making enough of the hormones (possibly estrogen, in you case?) the body needs to function with regularity.

My suggestion is that you have your estrogen levels checked and talk to a health care professional about getting your pituitary gland tested as well.

With regard to the vegan diet, it can actually lower your estrogen levels, so you may have hit on something there. Diets high in meat and dairy increase estrogen levels. Although a diet high in soy can increase levels too - a vegan diet often contains soy but some avoid it. Do you have soy in your diet? If not, then you may want to consider some since many studies show an increase in estrogen levels for those who consume it.

Please don't think that something sinister is happening or you will scare yourself senseless! It's not knowing that's the hardest (and the scariest).

Please have your estrogen levels checked and mention the pituitary factor while you are talking to your health care professional.

Has this helped in any way? Please keep us updated!

February 9, 2009 - 3:02pm

Hi there cyneller, I'm sorry you've been experiencing hot flashes and headaches. We posed your question to Dr. Daemon Jones, a naturopath specializing in diet. Here's what she had to say:

"In my experience women who have frequent hot flashes or increased frequency of hot flashes during and after menopause need to investigate the status of the adrenal glands. Once women move into menopause, their ovaries are no longer producing estrogen, progesterone, and androgens. The adrenal glands take over the production of small amounts of estrogen, progesterone and androgens after menopause. If a woman’s adrenal gland is working at maximum capacity (If you have a stressful lifestyle mentally physically or both) then the addition of the production of your female hormones taxes the gland too much and hot flashes result. It is possible that the vegan diet is the the best diet but it hard to tell with this brief history. I would suspect that the vegan diet is not giving you the right type of good fats and the right vitamins that she needs to support your adrenal glands and keep the hot flashes under control.

What to do about this? Get a work- up from a qualified naturopathic physician or holistic doctor using special test panels for the adrenal glands. Once you have confirmed that the adrenal gland is the source of the hot flashes your doctor will create a balanced treatment plan including nutritional support as needed."

For more information about Dr. Daemon Jones, author of Daelicious, Healthydaes, Recipes for Vibrant Living, visit Naturopathic Medical Center.

February 9, 2009 - 2:55pm
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