Which of the following is responsible for menopausal hot flashes:
Estrogen withdrawal is essential for the development of hot flashes (HFs). The mainstay in treatment of hot flashes is estrogen replacement. Thus, the answer would be 2.
A temporal relationship was observed between HFs and luteinizing hormone (LH) pulses. However, further work demonstrated that women with isolated gonadotropin deficiency had HFs but no LH pulses, and those with hypothalamic amenorrhea had LH pulses but no HFs.