31 y/o. had bilateral salpingo oopherectomy at 25. hrt nor recom. very active, lots of joint pain. what are alternatives to hrt?

Not many: First find out why hrt is not recommended. Is there a contraindication like blood clot or severe endometriosis. If not it actually is recommend for women in of premenopausal age, < 50 who don't smoke to protect the bones and general well-being. As for alternatives, other meds have been tried for treating hot flashes but not for other sx and they do not work very well.