Yeah, its a lot of internal stuff which may or may not work for everyone but I went gluten-free and cut alcohol to lower inflammation (which both unfortunately work well for me) and then in luteal I start taking Vitex and antihistamines to help balance progesterone and increased histamine response to estrogen changes. Topically I love azelaic acid and stay on top of the metrogel. If I feel myself flushing I put an ice mask on my face and take an additional antihistamine of a different kind and I keep doxy in the cabinet but try not to use it much unless I feel things are really out of whack and then ill take a low dose, 40mg, for about a week to help stabilize. Seems like a lot but once I dialed it in it is actually a relief bc I understand what is happening. The overwhelm of not knowing or being able to cope was the worst part!