Why hot flashes are still happening at 60
The question usually arrives with an apology attached. I am 60, I am years past my last period, so why am I still having hot flashes? The answer Dr. Martin gives is that your age was never the cause. The ratio between your estrogen and your progesterone was, and a ratio does not correct itself just because a birthday went by.
Dr. Martin on what he is actually looking at:
Dr. Martin, The Doctor Is In, Episode 815But ladies, estrogen and progesterone have to be equal.
He says the next line straight afterwards, and it is the whole basis for treating a hot flash at 60 as something you can still do something about.
Dr. Martin, The Doctor Is In, Episode 815It needs to be balanced. And I don't care how old you are. It needs to be balanced, right?
That is the frame for everything below. Not a level on its own. A comparison.
The three hormonal events in a woman's life
He splits a woman's life into three hormonal upheavals, and calls them events rather than illnesses. The first is menses. He has seen young girls with so much estrogen that heavy periods, bad skin, PMS and polycystic ovarian disorder come with it.
The second is having a baby. When the baby is born the progesterone is left in the placenta, and your body has to make its own again. His concern is what happens when it does not come back fast enough.
Dr. Martin, The Doctor Is In, Episode 815Then you can get all sorts of trouble because without progesterone, enough of it, your thyroid slows down.
He is describing the post-baby window there, and the trouble he lists with it is weight gain when nothing changed about the eating, and postpartum blues. The mechanism is what carries forward. Low progesterone, slow thyroid.
Then comes the third.
Dr. Martin, The Doctor Is In, Episode 815Now a third traumatic event, I call it turbulence, is when women come in to menopause, perimenopausal.
His picture is an aircraft coming in to land. You are not crashing, you are in turbulence, and the shaking is real while it lasts. Here is what he says the turbulence feels like.
Dr. Martin, The Doctor Is In, Episode 815And you can get mood swings and hot flashes and cold flashes.
He puts the rest of it in the same list: the thyroid off, sleep broken, the weight arriving. Notice that he never separates the flashes from the rest of it. They come as a set, because they come from the same place.
"It needs to be balanced. And I don't care how old you are. It needs to be balanced, right?"
Dr. Martin, The Doctor Is In, Episode 815Estrogen and progesterone: the ratio is what matters
This is the part most women have never had put to them plainly. Dr. Martin does not judge estrogen by its own number. He judges it against progesterone, every time.
His phrase is that estrogen is always a comparison. A woman needs balance. He contrasts that with a man, who he says needs testosterone high rather than balanced. A high estrogen reading only means something once you know what the progesterone is doing next to it.
So a hot flash at 60 is not him saying your estrogen has run out. It is him saying estrogen is running ahead of progesterone, and the gap is what you feel.
Two things widen that gap and neither of them is age. The first is that your own progesterone production has dropped away. The second is the estrogen arriving from outside you.
Why a normal blood test can miss it
You get the blood work, the estrogen comes back inside the range, and the conversation ends. Dr. Martin does not accept that as the end of it, and on this episode he is openly frustrated with it, endocrinologists included: your blood work is normal, you are going into menopause, what did you expect.
His problem with that is what the panel does not see. He says we have too much estrogen in the world, and a lot of it is not the estrogen your body made.
He calls them xenoestrogens, which he defines as every chemical your body reads as estrogen. It says give me, give me, I like that stuff. Then there are the phytoestrogens, soy and others, which he says lift your estrogen levels too. He calls this estrogen dominance, and he is clear it is not a woman's fault that she is swimming in it.
None of that shows up as a tidy number on an estrogen panel. So a normal result can sit on top of a real imbalance, which is why he treats the symptoms as information rather than as complaints.
The thyroid knock-on: tired as well as hot
If you are flashing and also exhausted, and the weight is climbing on the same food, he does not treat those as three separate problems. He runs them back to one.
Dr. Martin on where high estrogen lands:
Dr. Martin, The Doctor Is In, Episode 815And the problem with estrogen is the balance between estrogen and progesterone because if your estrogen is high, it'll affect your thyroid.
The next sentence out of his mouth is the mechanism. It will not allow the proper conversion of T4 to T3, and T3 is what your thyroid needs to function properly. Your thyroid can look like it is producing and still leave you slow, because the hormone is not being converted into the active form.
That is why he so often ends up talking about the thyroid in an episode that started with hot flashes, and why he says the thyroid never acts on its own. More on that in why the thyroid never acts on its own.
What to check before you put it down to age
None of this is a diagnosis, and none of it is a reason to stop something your own doctor put you on. It is the list he runs before accepting that 60 is the explanation.
- Whether the flashes travel with mood swings, broken sleep and cold flashes, which is the set he describes as turbulence
- Whether the fatigue and the weight arrived at the same time, which points him at the thyroid
- Whether anyone has looked at progesterone next to the estrogen, rather than the estrogen on its own
- What is going in and on you daily, since he counts soy and the chemicals your body reads as estrogen as part of the load
- Whether a normal panel was treated as the answer, when he says the panel does not see the whole picture
His instruction on the episode is short. Dim out the estrogen and elevate the progesterone. He is not telling you that you are ill. He is telling you the plane is landing and it does not have to shake this hard.
Common questions
Why am I still having hot flashes at 60?
Because in Dr. Martin's view estrogen is still running ahead of progesterone. He says the two have to be balanced and that he does not care how old you are, so he treats it as a balance problem rather than an age problem.
How long do hot flashes last after menopause?
He does not put a clock on it. He describes the menopause years as turbulence, something you are coming through rather than a fixed sentence, and his focus is on balancing the hormones rather than waiting it out.
Can hot flashes be a thyroid problem?
He links the two. He says high estrogen will not allow the proper conversion of T4 to T3, so the thyroid slows down and fatigue and weight gain travel alongside the flashes.
Does estrogen cause hot flashes?
Not estrogen on its own, in his framing. He says the problem is the balance between estrogen and progesterone, and that estrogen is always a comparison rather than a number you read by itself.
Read next: Should A Woman Over 60 Take Estrogen? and Can You Still Be In Menopause At 70?.
Where Hormonal Support Formula fits
Martin Clinic's Hormonal Support Formula is the one Dr. Martin points women at when the aim is to dim the excess estrogen and bring it back into balance with progesterone.
60-day money-back guarantee. It is one of the three he talks about most, and all three are in The Big 3 bundle.These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. Always consult your healthcare practitioner before starting a new supplement, especially if you are pregnant, nursing, taking medication, or have a medical condition.
