Surgical menopause in 2008, still haven't had what I would consider a "full" heat flash - at least not what others described and I've never had HRT. I get a little warm sometimes, and I had problems sleeping for a couple years which, in retrospect, was probably due more to "the change" than anything. I do go quickly between stacks of cover at night to just a sheet sometimes, but it isn't extreme. I've noticed that I DO have much more of a problem getting warm in the winter than I once did, and I enjoy hot weather far more than I once did. Unsure if that's from getting older, from being much smaller than I once was, being 8 years post-surgery or all of the above (probably).