From what I've read on this forum, there are cases where breast cancer in the family doesn't exclude you from being able to have hrt. I'm not sure how that works and if it's even a risk you're desperate enough to entertain. Also, how about antidepressants? I think there is at least one that is prescribed for hot flashes, and they are supposed to help anxiety. Again, I don't know much about them but I wonder if they help the foggy head feelings too.
Aside from those medical options, lots of women talk about meditation exercises, yoga, walking and other exercise. Obviously those are great options. Personally, I love to be fit and moving but I know when I'm in that "off" feeling it all seems futile. When I'm feeling good, I make sure to try to get in some exercise. And when I'm not, I at least do some stretching, yoga, whatever I feel like I can handle. It can't hurt.
It actually helps me that my husband is constantly reminding me that my menopause is different. Somehow the little reminder that my hormones are acting up reassures me when I'm feeling cloudy-headed that it will eventually all level out.