Hot flashes are not simply the price of admission to menopause. They are a dynamic signal of neuroendocrine stress, metabolic inflexibility, and sympathetic overdrive—often amplified by inefficient catecholamine clearance. Emerging evidence from Jerilynn Prior’s work with oral micronized progesterone 300 mg, alongside the arrival of neurokinin-3 (NK3) receptor antagonists like fezolinetant, now allows a more nuanced and mechanistic approach to vasomotor symptoms (VMS) that goes far beyond “give estrogen or not.”pubmed.ncbi.nlm.nih+5
