@gwinter I underwent surgical menopause at age 44 (removal of uterus and ovaries). It was brutal. At that time they gave us estrogen pills twice daily which helped immensely but then the Women's Health Study came out and that was stopped. I think back then my Gynecologist gave me some sort of psych pill for a short time, but I don't remember the name. I do take my aromatase inhibitors at night and will awaken with sweats, but daytime hot flashes are minimal then. They tend to start about an hour after I take my pill. I stay away from alcohol as that tends to start them off more. I've also upped my exercise doing water time and a lot of walking. I think staying active helps a lot. With the fire here in northern California, I have both of my kids' families and animals living with us so am doing a LOT of cooking and baking and having huge hot flashes...I have one of those little fans that hand around your neck and it helps immensely!