The conventional wisdom has been that hot flashes are caused by a drop in the hormone estrogen that occurs around the time of menopause. She believes that these occur as hormone levels in the body actually fluctuate prior to the decline that accompanies the end of menstruation.
Many American women experience hot flashes and symptoms of menopause.
Symptoms may start a few years before menopause and may last several years after. That is not very common. If Dr. Love's theory is correct, then it may follow that whatever dosage and cocktail of hormone replacement drugs you are taking is just not the right formula for you. Ask your doctor about adjusting the dose or changing formulas. Also, if you have been on hormone replacement therapy continuously for 20 years, you may want to talk with your doctor about gradually stopping the medication, because there are some risks that increase with long-term use.