This is Dr. David
I am sorry about your wife's bad hot flashes. it sounds like she has been suffering with them for a long time now.
often times paroxetine can help decrease hot flash symptoms, but it doesn't sound like they are working for her.
for many woman, effexor or venlafaxine can help decrease hot flash symptoms, but usually this shouldn't be taken with paroxetine
she can go on low dose estrogen therapy like in a birth control pill sort of level, but this has very low risks for causing blood clots and with her PE history, most doctors won't want to give her estrogen hormone.
she should get her thyroid hormone levels checked to make sure they are in normal range.
it sounds like she has tried over the counter agents like Black Cohosh already, correct?
she should try acupuncture to see if that helps with her hot flash symptoms. has she tried this?
let me know if you have other questions.
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