The best thing I ever did to end the monthly insanity was remove the uterus.(Major league fibroids, bleeding, very bad quality of life) Kept the ovaries cause I was only 43 and not ready for menopause. When the hot flashes, moodiness and sleepless nights started I read all I could on HRT and chose to go with bio-identical replacement therapy. Best thing I've done in a long time. I get tested twice a year to see if my levels are still where they should be, I am on the lowest dose possible in cream form so no liver issues and I'm a happy camper.
I'm not a big prescription person, quite the opposite but since most hormones are abundant for much of our most active and healthy early years and can be safely added back when they wane, why suffer if you are really miserable?