Brief Answer: Hot flashes Detailed Answer: You are correct in understanding that hot flashes are uncommon at your age. However they can still continue to occur in some at this age. HRT is considered a good option in early menopause provided the risks do not outweight the benefits. But at your age it is not deemed as safe. Non-hormonal options for management of hot flashes include gabapentin, clonidine and SSRI's. Selective-serotonin reuptake inhibitor (SSRI) drugs and serotonin norephinephrine reuptake inhibitor (SNRI) drugs are useful in treating both depression and hot flashes. Gabapentin, an anti-seizure medication, can be used to treat hot flashes, particularly at night when hot flashes can disturb sleep. Clonidine is a blood-pressure-lowering drug that is sometimes used to reduce the frequency and severity of hot flashes. However, this drug is rarely used because it can have unpleasant side effects such as dizziness, dry mouth, and constipation. It would be best to discuss the pros and cons of these medications with your Gynecologist.

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Brief Answer: Tests Detailed Answer: If you are certain these feel just like the hot flashes then no further work up is necessary. However, the evaluation of an individuals with 'spells' ie symptoms that occur periodically with diverse manifestations like flushing, sweating etc is extensive and depends on an in-person assessment. In general it is good to rule out a couple hormonal problems like: TSH and free T4 (to see if you are getting too much thyroid medication dose) and Plasma fractionated metanephrines (to rule out a rare benign tumor called pheochromocytoma) If you experience wheezing too, then a 24 hour urine test for 5HIAA can assist in diagnosing Carcinoid syndrome

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