Just to second the use of HRT.
Not sure about 'this forum being very pro HRT' 
I am pro HRT because I've used it for 10 years, it works, I feel great, it enables me to work still in my 60s, help look after my ill, ageing parents, my own kids etc. It also helps my bones, heart, pelvic floor and brain.
I am quite happy to be PRO HRT - take that or leave it!
If you can manage with sage, herbs and whatever else that's great. Really. But some of us tried all of that first and it did nothing at all.
I haven't had a drink for 25 years. I don't drink caffeine at all. I have really healthy diet, don't do sweets, puddings, any kind of junk food, and I exercise. My dr agreed there was nothing else to try, in terms of lifestyle. The good aspect was I had no peri symptoms till I was about 52, nothing, so lifestyle helped. But the minute my periods stopped, I got insomnia, flushes and hot at night.
Soooooo....if you do all the lifestyle stuff first, you might be okay. But it might not .
All the medical research out there shows that HRT for women up to 60 at least has benefits that outweigh any risks. The risks don't apply anyway before the age of normal meno- so that's 51/52.
It's not a Big Deal. It works, it gives you quality of life, and it also protects your long term health.
But as ever, it's your call. Some women are anti it (but can't say why) or are prejudiced for some reason. Fine, their choice.