Hot flashes are unlikely to be a symptom of increasing or increased E2, and more likely to be a symptom of decreases in E2 levels or low E2.

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SpyrosB

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After reading up a ton of literature on Estrogen effects on males, there's really a whole bunch of realisations about how extremely useful it is in male function and consequently how misunderstood and mishandled it is by men or TRT clinics. I'm glad Nelson seems to have a much better understanding of that than most clinics and clearly attempts to educate about E2 in the forums. But in this thread I wanted to focus on hot flashes specifically.

Effects on the male endocrine system of long-term treatment with gonadotropin-releasing hormone agonists and estrogens in male-to-female transsexuals
This is a study of the effects of hormonal replacement in men, who underwent HRT for transition purposes. They examined the effects of chronic supplementation of oral estradiol along with a GnRH antagonist on their hormonal profiles over a 24 month period.
"There was a significant decline in T by 97% to 0.52 and 0.59 nmol/l, respectively. Estrogen levels were significantly increased after 12 and 24 months of cross−sex hormone treatment from 77.51 to 677 and 661 pmol/l, respectively."

As is to be expected, T levels were nearly eradicated, and E2 rose nearly 10fold.
SHBG levels also more than doubled, for those who might find this interesting. Oral E administration is known to increase SHBG by effects provoked by liver metabolism. (Useful information for men who can't seem to escape low SHBG).

The interesting part however is that none of these men whatsoever complained of hot flashes, at any point - over 24 months. That's a 10 fold, chronic increase in E2 levels in 40 men alongside eradication of T and endogenous production. 0 hot flash reports.

Meanwhile, hot flashes are commonly experienced by men undergoing androgen deprivation therapy (but do not supplement with estradiol)[source]. With androgen deprivation of course follows significant reduction in estrogen levels. Funnily enough, hot flashes are treated in those men with estrogen supplementation... [source]

Hot flashes are also experienced by women undergoing estrogen deprivation therapy (for gynaecological cancers for example) by the use of AIs by the way, or blockers like tamoxifen(nolvadex)[ERC] the side effects of which are characterised as "menopause side effects" due to their similarity[ nhs , cancer.org ]. Furthermore, as you may have surmised by the previous statement, hot flashes are also a common, hallmark symptom of menopause, where the predominant factor is significant reduction in estrogen levels.

There's a ton to say about E2 and how AIs should never be anything more than a short-term low-dose intervention at best in TRT plans, but I'll leave that for another thread.
 
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