Final answer:
The hot flashes during menopause are primarily caused by decreased estrogen levels. Doctors might hesitate to recommend hormone replacement therapy due to risks such as increased chances of cancer and cardiovascular problems, even though it can alleviate menopausal symptoms.
Step-by-step explanation:
The cause of hot flashes associated with menopause is (a) decreased estrogen. During menopause, estrogen levels fall, leading to a range of symptoms including hot flashes, night sweats, and more. These changes are associated with the cessation of ovarian function, which leads to a decrease in the production of estrogen. As a result, hormone replacement therapy (HRT) can be used to supplement estrogen and alleviate these symptoms, but doctors may be hesitant to recommend it due to the associated risks of HRT — such as increased risk of heart attack, stroke, breast cancer, and other conditions.
Although HRT can help with bone density and cardiovascular disease, the potential risks sometimes outweigh the benefits, especially after considering the outcome of the Women's Health Initiative study terminated due to cancer risks. The use of HRT is generally limited to the lowest possible dose for the shortest possible duration, typically five years or less, and requires regular health check-ups for those using it.