I had a hysterectomy and ovarectomy at the age of 43 and immediately went into menopause. I began having hot flashes every two hours, day and night. My doctors gave me oral hormones (estrodial and testosterone) but they gave me migraines. I was getting between two and four hours of sleep. Finally a new doctor put me on the estrodial patch and topical testosterone. The hot flashes are much reduced. I have none during the day and am getting six hours of sleep a night. I also began to have vaginal atrophy and compounded estriol has really helped with my ability to urinate.