Hi, Thank you for the query and Welcome to HCM forum. Hot flashes and sweating, Sleep disturbances, Irregular periods, Anxiety and/or Depression are the symptoms of Peri-menopause. For Hot flashes, i advice you the following : 1. Keep the temperature of your room low 2. Avoid hot fluid like tea and smoking. 3. Avoid smoking and Alcohol. 4. Dress in layers so that you can take off clothes if you get hot. Put a wet, cold cloth around your neck during hot flash 5. Go to the bed and get up from bed same time everyday even you don t sleep well. 6. Stay active and Do some exercises everyday. 7. Seek social support from women like you. In addition to the above measures, Hormone replacement therapy may be needed, Sleep medication like Eszopiclone improve the mood and sleeping problem. Anti-depressant and Anti-seizure medication are often helpful. At the Beginning of the Hashimoto s thyroiditis, hypothyroidism is often absent. But, over the time mild or overt hypothyroidism is developed and for that, lifelong treatment with thyroid hormone is needed. Consult with an endocrinologist for effective management. Hope, this helps.