Hello K., I had a complete hysterectomy at age 30, after many years of Endometriosis pain and near constant bleeding. Immediately after surgery the surgeon injected me with a huge dose of hormones, then prescribed Premarin, at the highest dosage level. I found out that this is a normal course of action by the surgeon after hysterectomy. I am a small person, less than 120 lbs, so the large amount of hormones coursing through my body took over my life and I hated everyone and everything--including myself!!! After multiple arguments with my surgeon regarding the high dosage of hormones making me crazy, he ended up telling me that he was the doctor and my opinion was not requested or wanted. That moment is when I understood that he was a surgeon, not a doctor that truly cared about me or my quality of life. I began to ask questions, basically anyone that would listen to me, and was advised to see an Endocrinologist. The Endocrinologist explained exactly how the hormones work, how critical they are to our overall health and daily functions, and told me that dosage was relative to a person's specific needs and there was no "one size fits all." He started me on the lowest dose available, then checked me every two weeks to adjust the dosage until "we" had figured out the correct dosage for me based on how I felt. I did not have hot flashes, just crazy mood swings. I am now 59 yrs old and continue to use HRT. I now have a family doctor that uses "compound" prescriptions, each tailored to my specific needs, so the mixture of estridiol, progesterone and testosterone are compounded specifically for me and closely monitored and adjusted as needed to meet my changing needs based on my lifestyle, stress levels, health changes and any other contributing factors. The hormones I use are bio-identical, all natural, prepared in a transdermal cream that I rub on my inner thigh each day. My first thought for your situation is that they gave you too much hormones in your initial injection after surgery, which could be the reason you are hot all the time. I was told the hormone injection would last over a month, so do not start the oral hormones until your body settles down a bit. Additionally, a woman produces hormones in her fatty tissue, so if you are overweight, your body may be producing lots of hormones by itself and coupled with the injection, you are overloaded with hormones. The Premarin has a high estrogen value and I do not recommend it because of the increased cancer risk that creates and also because you need progesterone and testosterone to go with it. I would suggest you find an Endocrinologist, specifically one that uses compounded meds, to work with you to balance out your hormone levels. The hormones not only help prevent Osteoarthritis, they help keep your skin healthy, they help keep your vaginal walls elastic, they help prevent vaginal dryness, they help you sleep, they help your brain function--memory and clear thinking, and help maintain a more consistent mood and energy level. I know women that have opted out of HRT, their skin aged super quick and they look old, wrinkled, worn out and have no energy. Of course, there are other contributing factors to that equation, smoking is a big NO NO with HRT, and a healthy diet along with regular exercise will improve your life greatly and help with the hormone levels. Good luck, and always remember, you are your best informant for what is working for you and what is not. Never be afraid to voice your opinion and ask questions of any medical expert that you encounter. Also, the internet is full of good information, it is also a big bucket of bull, so do your research, but make sure the information provided is backed up with solid citations of where the info originated from and how credible it is. Hope you manage to "turn down the heat" soon and feel better fast!!!