Mchllwlkns - I quite understand. To help prevent bone and heart issues, I would really look at diet, exercise and lifestyle generally. Relaxation techniques are really helpful and an essential part of my coping strategies.
You could still have local oestrogen if you develop urogenital atrophy (dryness, soreness, UTI type symptoms, urinary problems) as this isn't absorbed systemically so I doubt this would put you at risk. I would certainly get into the habit of using vaginal moisturisers e.g. SYLK or the YES products are the best, and these can be bought online.
Things that can help to reduce flushes are:
No caffeine or alcohol.
No Hot spicy foods.
Eat small amounts often to prevent low blood sugar - you will find that low blood sugar due to not eating will make flushes worse.
You could try eating foods high in isoflavines ( e.g. Soya) and possibly take Red Clover?
Take Omega 3, calcium, vitamin D and magnesium.
These are just some of things I do to help me cope. I had a premature meno that started in my mid 30s and though I used HRT on and off for 25 years, I am now in my early 60s and doing without HRT - it's still hard though. DG x