I had 50+ hot flashes a day. My doc put me on an adrenal support supplement (all natural). I don't feel that hot flashes need to be addressed with drugs, there are natural alternatives that are effective. I get no side effects and have not hot flashed since I started taking the supplements regularly.
From how it was explained to me, since I wore down my adrenals living a stressful life, I needed supplementation to build back up my adrenals. I reduced my stress and started doing yoga as well.
Hot Flashes are your bodys way of trying to regulate it's temperature, that's where the adrenals come in... when those are not working properly.. your body can't regulate.