Hello, Thanks for your query on HCM As per your clinical history is concerned please follow like this - 1)Do a clinical exam by your treating Doctor[gynecologist]and talk about low dose [estrogen]therapy for hot flashes. 2)Do take OTC digestive enzymes for bloating and gargle throat with warm saline three times a day for PND. Do follow few lifestyle modification like this- 1)Try to pinpoint what triggers your hot flashes like hot beverages, caffeine, spicy foods, alcohol, stress, hot weather and even a warm room. 2)Decrease vaginal discomfort. Use over-the-counter, water-based vaginal lubricants (Astroglide) or moisturizers (Replens). 3)Get enough sleep. Avoid caffeine, and avoid drinking too much alcohol, which can interrupt sleep. 4)Practice relaxation techniques. Techniques such as deep breathing, paced breathing, massage and progressive muscle relaxation can help relieve menopausal symptoms. 5)Try to strengthen your pelvic floor. Pelvic floor muscle exercises, called Kegel exercises, can improve some forms of urinary incontinence. 6)Eat a balanced diet. Include a variety of fruits, vegetables and whole grains. Limit saturated fats, oils and sugars. Ask your doctor if you need calcium or vitamin D supplements to help meet daily requirements. 7)Don t smoke. Smoking increases your risk of heart disease, stroke, osteoporosis, cancer and a range of other health problems. It may also increase hot flashes. Hope that helps