I am 56 and have terrible hot flashes, especially at night. I have tried black cohosh, to no avail. What do you think of Prempro.
You have made one mistake, and you are about to make a second. Black cohosh is a selective estrogen receptor blocker, and it really does not do you very much good; the problem that you have is estrogen dominance. Black cohosh is very difficult to use, and that would not be what I would recommend.
In order to deal with the hot flashes, the first thing I would do in my practice would be to get blood work and find out what the progesterone level is. Hot flashes, more times than not, do not come from estrogen excess, but from progesterone depletion. It is a problem with the ratio of estrogen to progesterone. The ratio should be 80:1.
What you can do in the meantime is increase your Vitamin D3 level. Vitamin D3 is a selective estrogen receptor blocker. Doing this will help you with the hot flashes and other ways as well, but I would also be investigating progesterone replacement.
Prempro is a mixture of Premarin with progestin, which is the exact opposite of what your body needs, and it is about the worst way to approach your issue.