How can you most effectively end menopausal hot flashes without using hormone therapy?

Wait: Most will resolve with time. Some women benefit from Clonidine 0.05 mg twice a day or ssri's. Check w/your doctor.

Botanicals can help: Botanical medicine can be helpful for menopausal hot flashes. A couple possibilities include black cohosh (cimicifuga racemosa): http://www.Ncbi.Nlm.Nih.Gov/pubmed/22157510 and sage (salvia officinalis): http://www.Ncbi.Nlm.Nih.Gov/pubmed/21630133 classical homeopathy with an experienced homeopath is also useful. Traditional chinese medicine & acupuncture as well.