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I had tried all kinds of various over the counter treatments for hot flashes. Hot flashes doesn't begin to express what these things are like. You can't even think during one - you feel like there are hot coals on the inside of your body going outward. After 2 years of trying different things - I used black cohash - and it started working within 2 days even though I really didn't expect it too. So many of the health stores I went to, wanted to start me on a plethora of vitamins, none of which ever helped. Soy didn't seem to help, neither did the over the counter products from retail stores. Then my gyn tells me I really need to be on the estrogen to keep my bones strong, be heart healthy, etc. -- so i start all over again. nothing works. pills. shots. sprays. some work for a month or two months. some take a month to work then couple months later back to square one. what to do?? do i ignore my dr. and go back to the black cohash? Most women my age don't seem to be having it as severe as I am, or as my mother before me did. My mother is still on meds and still has hot flashes at 68 years of age!