Mine started around 50, & I spent a fortune & 3 years trying every 'alternative' under the sun (had some success with a British herbalist but it was shortlived). When I was thoroughly exhausted from sweating on the hour, every hour I 'succumbed' to HRT & finally found relief.
8 years on it now, & frankly, I'm not coming off! Not all women get to the other side of the meno after a couple of years & I'm not returning to that miserable time in my life without a massive fight. Will have to change my HRT now as Premique Low Dose has been unavailable for a few months so I'll try Femoston Conti low dose instead.
In my early "I don't want HRT" days I had limited success with Clonodine, flush free from about 7am - 3pm when weirdly the flushes used to kick back in.