I've been on HRT for 3 years, but not before trying other things first. When I started getting bad hot flushes I was prescribed Clonidine, which worked very well for a couple of years. Then I had a really bad period (which turned out to be my last) and the flushes started up again with a vengeance, even though I increased the dose of Clonidine from 2 to 3 tablets per day. I was just sweating all the time.
I tried Black cohosh, and that did calm things down a bit, but not to the point where I had a reasonable quality of life. I'm the correct weight for my height, go to the gym, eat healthily, don't smoke and rarely drink, so I feel that the only risk factor in my life is taking HRT, which has worked wonders for the flushes and I feel so much better on it. I've since been diagnosed with low bone density, so that seems to be another thing in favour of HRT.
When I eventually come off HRT, I will ask my GP to let me try Clonidine again if I start getting flushes, as it worked before. However, I'm 48 now, so I expect to be on HRT for another couple of years, until I reach normal menopause age.
Marina