Interesting question because when I described my hot flushes to the menopause nurse at the specialist clinic, she said, no, mine weren't hot flushes at all!
Regardless, my experience was three months after I turned 51, my periods stopped suddenly (after being perfectly regular for months) and I began to get sudden feelings of unbearable overheating. I'd take off clothes, used numerous fans and would run outside to sit in the cool and hopefully I'd have been quick enough, cooling myself to avert the full force of the flush, which would leave me dripping wet, literally wet through my clothes, needing to change all my clothes, but I had no redness.
Sometimes I would spend miserable days both too hot and too cold at the same time, both sensations screaming at me to act now in opposing directions, so I'd shiver and sweat and I'd be reminded of how opiate withdrawal feels, completely unable to reach anything approaching a comfortable way to live.
It would come on with any stimulation. Talking to another person would make my system overheat, as would doing housework or hitting a small problem in work.
It also came on with no stimulation at all, random flashes of heat, sweating, but the menopause nurse said a hot flush isn't like all that!
She said a hot flush is a redness slowly creeping upwards over your chest and then face. I never had anything like that happen, no redness, no creeping, only heat, cold, sweating and shivering, sometimes cycling wildly back and forth over the space of a few minutes, going on for hours.
I'm 55 now and as I don't like any of the progestins I've been allowed so far, I take tibolone, which isn't HRT, but it does replace some hormones so I don't care what they call it!
Tibolone works for me, not even any night sweats these days and I previously had to sleep wrapped in four towels that I would throw out of the bed as each became soaked. Electrolyte imbalances were fairly inevitable with that amount of potential for dehydration too.
I had tried evorel patches to start, then estradot patches (twice as effective), then Oestrogel, which easily felt ten times stronger per dose than either patch and it seemed that oestrogel might work, it cheered me up, but it didn't stop the flushes. I have a diagnosed condition that makes my skin significantly different. For example in allergy testing at the hospital, the consultant said the skin tests were void because my skin didn't act properly with the control.
It would be no surprise to me if I wasn't absorbing it, tibolone comes as a tablet, one a day in a "days of the week" pack, very like the pill. That, I can absorb.