For quite a while I used Organic Alcohol Extract of Fenugreek Seed and also Extract of Wild Yam for Hot Flashes, twice a day and it really helped a lot. My sister passed from breast cancer so my doctor wouldnt give me any HRT but this helped a lot. Another doctor did give me Bioidentical hormones and that has helped the most but if I didnt have that, I'd be taking the fenugreek & wild yam extracts in water 2 x a day. I haven't tried the ACV but I plan to. I'd much rather take it than any hormones, bio-identical or not.