Hi . I am not an expert at all but all I will say is I have had to go on vaginal oestrogen, and I really didn't want to but my life quality of life was starting to become miserable, and being without sleep is the pits. So I would think seriously about HRT especially if you drive as lack of sleep from the flushes could be dangerous when driving, my friend fell asleep at the wheel and went onto HRT for a short while to get her over the worst.