I can tell you that I did not go on any hormone replacement therapy against dr. orders. I did have a couple of hot flashes but I controlled everything with herbs. Black Cohosh is the first thing I tried. Then I added Evening Primrose oil and Black Current. I put some other things in at times but if you do a search on herbal remedies you will get some idea of how I went about it. It works but you have to stick with one thing to see how you do and then add something else. Herbs don't work fast and sometimes it takes 6 weeks or more to get a result. But if you're like me and don't want to do HRT you will find a way. I sailed right through it and didn't have any depression or night sweats!