I'm almost 59 so I've already dealt with much of this. I don;t take anything but calcium and just go with the hot flashes. I kick the covers off at night and during the day I just try to focus on something else until the heat passes. Since I'm on the far end of the whole process, the most irritating thing has been the intense itching from dryness. My GYN recommended Replens which I love! It's hard to find...sometimes Walgreens of CVS carries it but I order from Amazon.
It's certainly an interesting ride!