Young women don’t talk about it because they are clueless and old women don’t bring it up because they want to forget. I found big improvements with (1) no sugar (2) reasonable, regular exercise daily (3) stress relief [I used the Buteyko breathing method], and (4) improving my blood sugar stability which involved a keto diet. I found I could no longer tolerate alcohol so I gave that up, too. Most doctors wont recommend any of this. All this eliminated hot flashes 90% within a month and completely within 2 months. I lost weight & my mood improved. Fixing the sleep problem has taken much longer & seems mostly related to stress. Good luck to you.