Hi Confused 123 and Dotty,
I'm 56, 4 years post meno, and have had a lot of the same symptoms you describe which started 2 years after last period. I started HRT and have been using it for a year and a half. I am not perfect (not that I ever was...) but things have definitely improved overall. It's kind of up and down, and you catch me at a pretty good moment. Joint aches have mostly gone, brain is a lot better, as is fatigue. Mood is still variable, but definitely better than two years ago. The daytime flushes stopped almost immediately when I started hrt, but the night flushes have never really stopped - reduced, but I still wake every 2-3 hours feeling hot.
I use the gel, two pushes, one in the morning and one at night and duphaston (I'm not in the UK).
Also, as you say, diet and exercise I think have helped a lot. I walk a lot and eat pretty healthily. Cut out sugar (mostly) two years ago on the advice of a wonderful acupuncturist (who helped with aching joints) as he said it would help with brain fog, and I think it has, together with the hrt, as fog has lifted a lot.
It's been a really slow, gradual process for me, and I'm not 100% better, but so much better than I was.
It really is a horrible time. I hope you both find things that help and that you feel better soon.