I was severely afflicted with hot flashes for 5 years. I tried every herbal/dietary approach you can imagine with no relief. It was greatly affecting my sleep, waking me every 1-2 hours throughout the night. I was beginning to feel very depressed and hopeless. I finally started on the bio-identical hormones in January of 2020. Over the course of about a year, my practitioner gradually increased my doses until we hit the sweet spot. I finally am hot flash-free. I sleep so much better, and I don't have to carry a fan around with me at work. It is impossible to explain to someone who hasn't lived with the impact of severe hot flashes the extent of the negative effect on daily living. Bio-identical hormones have given me my life back!