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I was at brunch last spring with my friend Patti. She grabbed a menu and started fanning her neck.
“Still?” I said. She put the menu down. “Diane, it’s been six years.”
Her doctor had told her two. Maybe three. But that was 2020.
Patti thought she was the exception… the one woman whose body forgot to stop. And she’d quit bringing it up at check-ups, because what do you say after half a decade?
Maybe you’ve done the same math. You counted months, then years, waiting for a finish line that kept moving.
Here’s what the largest study of its kind found…
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Your brain has a built-in temperature gauge, tucked inside a region called the hypothalamus. Estrogen held it steady… for decades.
Think of a ceiling fan on high. The blades spin smooth and steady for years. Then you flip the switch. But the fan doesn’t just stop. It wobbles… slow, then fast, a little shudder, a little coast. And it keeps going a long time before the blades finally rest.
That’s your hypothalamus now. Estrogen kept the spin smooth. As estrogen falls away, the gauge wobbles… and every wobble fires a flash. Your brain reads a tiny rise in core temperature as an emergency. And the sweat hits.
The SWAN study followed 1,449 women for up to 17 years. Median duration of frequent hot flashes: 7.4 years. And women who started in premenopause or early perimenopause lasted a median of more than 11.8 years.
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Surgery Won’t Fix Your Leaky Bladder (But This 7-Second Ritual Will)
My name is Dr. Sarah Pachtman Shetty and I want you to know that you’ve been lied to when it comes to pee leaks.
❌ “It's normal after kids/getting older.”
It's COMMON, not normal. And common means it can be fixed.
❌ “You need surgery to fix it.”
❌ “You just have a small bladder, it must run in the family.”
No it doesn’t. That’s just an excuse doctors make up to avoid treating you.
Your bladder CAN be reset in just 7 seconds a day. You don’t need invasive surgery, annoying kegels or toxic pills.
I made a free video showing you exactly how:
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Nobody tells you this part. They say “hot flashes” like it’s a season… something that blows through and ends. So when yours keep coming year after year, you feel like your body is doing it wrong.
It isn’t. In the SWAN data… more than half of women had frequent flashes past 7 years. And women whose flashes started early lasted the longest. The real timeline just never reached you.
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A few things that may help, starting tonight |
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| Tell your doctor the number. Count how many months or years your flashes have lasted. And say that number out loud… because it changes the whole treatment plan. |
| Ask about CBT for hot flashes. Cognitive behavioral therapy is a short, structured program that changes how you respond to hot flashes so they bother you less. The Menopause Society recommends it. |
| Bring up a non-hormone prescription. Fezolinetant, sold as Veozah, is FDA-approved for moderate to severe flashes. It works on the brain’s heat switch, not on estrogen. |
| Revisit the plan every year. The flash pattern shifts as your brain adjusts. A treatment that missed two years ago… may land now. |
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My feed this week is full of “seed cycling” for hot flashes. Eat flax and pumpkin seeds for two weeks, then sesame and sunflower for two. The promise: your hormones rebalance… and flashes fade.
Here’s the grain of truth. Flaxseed does contain weak plant estrogens called lignans. Some small studies show a modest dip in hot flashes.
But the rotating schedule has zero clinical trials behind it in menopausal women. A 2025 review found ten studies, all in younger women with cycle problems.
Seeds are fine on toast. The protocol is made up.
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The words to bring to your appointment
“I’ve been having hot flashes for [number] months or years. I was told they’d pass quickly, but they haven’t. Can we talk about what treatment makes sense for this timeline?”
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Of course, every woman’s clock is different. And I could be wrong about yours… So bring the numbers and the timeline, and let your doctor build a plan that fits.
Start with one tip tonight…
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Are your hot flashes lasting longer than you expected?
Just a quick poll. Your answer helps me choose what to cover next.
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We'll figure out the rest together.
— Diane
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P.S. If someone you love is in the thick of it, forward her this email. Sometimes just knowing the real number takes the edge off the wait.
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