Ladies do NOT assume that irregular periods are the norm pre-menopause. They can also mean something is wrong. In my case it was ovarian cancer. Even tho I told my doc he blew it off as pre-menopause too. Back pain, bloating, cramps, spotting, bad periods, mini periods, etc, are all possible symptoms of ovarian cancer. Age 49-50 I had periods all over the map. Age 51 I went 9 months with no periods & then had the worst period in my life. Took me 3 trips to the doc, many Urine tests, internals, a CT scan & cancer tests to finally show I had what they called a "Cyst". 3 docs told me they didn't think I had cancer. July of 2009 I had a Total Hysterectomy, plus lymph glands removed & that "Cyst" turned out to be a softball sized tumor on left ovary, that leaked cancer cells into abdominal fluid. Ended up doing chemo. My gyn/oncologist said he thinks I had this tumor for at least 2.5 years! So don't let your docs blow you off if you feel something is not right. Push for testing to make sure. You'll be glad you did if it is cancer. The sooner you find it the better your chances of survival. Most, who are diagnosed with OC wait too long & by the time they get a diagnosis it has spread. Docs often miss it, as they assume it's just menopause. OC is called the "Silent killer" do to the lack of symptoms. Also your chances of getting any of the female cancers increase during or right after menopause. So please get tested.
As for hot flashes...I had them for years before this happened & have been soaking the sheets, clothing hair, etc ever since. My winter coat has been a fleece shirt & I only wear spaghetti strap summer tops year around. I swear if I could find a market for heat & sweat I'd be rich! Sleep is a joke. 4 hours max is all I can sleep at any given time. I have 2 fans blowing on me in bed. I sweat, then freeze, because I'm wet. I told my docs you could use me as a salt lick at any given moment, LOL.
My docs all tell me NO estrogen period. No OTC or alternative stuff either, as it also has estrogens in it. I'm not even supposed to eat plant estrogens. Not possible, as most all veggies & fruits contain estrogens.
I remember my Grandmother, who had a hysterectomy in her mid 40's, was on estrogen into her 80's, had hot flashes all the time. They never stopped for her.