For what it is worth here is my 2 pennyworth. I chose not to take HRT with the thought that if my quality of life became intolerable I could always try it.
At the start of my menopause I suffered with insomnia, hot flushes and vaginal atrophy. I have always used St John's Wort as I reacted badly to SSRIs and SJW keeps my mood on an even keel so that was not too bad. But SJW has to be used carefully as it can interact with other medications but it works for me.
I have a very open minded lady doctor who listened to me a lot (highly recommend that if you can get one) and she introduced me to Ovestin and later Vagifem and Gynest cream for the vaginal atrophy. Perhaps that could be referred to as HRT but I did not take full HRT and that was my choice.
For my hot flushes I used a fan and a Magicool spray, I had about 18 months when they bothered me but just this year have become milder and less frequent.
The insomnia was nasty and I was almost on the point of asking for sleeping medication when, after about 9 months of it, it started to improve.
Do you know the one thing I found to really help during all this? Reading threads and posts on this forum helped after my doctor told me about it (I did not register for another 2 years). It told me that what I was experiencing was not unusual and there were options if and when I wanted them but I never got to that point of not being able to cope. Perhaps I am one of the lucky ones. I am not out of it yet but I have moved on and it is not so bad now.
I would say finding out all you can about it all (thank you MM) helps too
Oh yes, and a supportive, patient partner/husband really helps if you have one
![Smiley :)](https://www.menopausematters.co.uk/forum/Smileys/extended/smiley.gif)
If this sounds trite and simplistic I apologise but as silverlady said, the thread is about ladies who don't use HRT and I am one of those.