Hello, Thanks for your query on HCM As per your clinical history is concerned please follow like this - 1)Check your [Complete blood count with differential and TSH level of blood] 2)Discuss with your treating Doctor about [Iron, Vitamin-B 12 and Calcium]supplements regularly. 3)Regarding hot flashes talk with your Doctor about [low dose estrogen therapy] and regular oral calcium to prevent osteoporosis of bone. Do take preventive steps like this for fatigue and hand pain- 1)Take Iron-rich foods like beef and other meats, beans, lentils, iron-fortified cereals, dark green leafy vegetables, and dried fruit. 2)Take folic acid, and it can be found in citrus fruits and juices, bananas, dark green leafy vegetables, legumes, and fortified breads, cereals and pasta. 3)Take Vitamin B-12 and this vitamin is found naturally in meat and dairy products. 4)Take Vitamin C and foods containing vitamin C such as citrus fruits, melons and berries which help increase iron absorption. Do take following preventive measures for menopause- 1)Try to avoid hot beverages, caffeine, spicy foods, alcohol, stress, hot weather and even a warm room. 2)Decrease your vaginal discomfort. Use over-the-counter, water-based vaginal lubricants or moisturizers. 3)Get enough sleep. Try to avoid caffeine, which can make it hard to get to sleep, and avoid drinking too much alcohol, which can interrupt sleep. 4)Exercise during the day 5)Practice relaxation techniques like deep breathing, paced breathing, guided imagery, massage and progressive muscle relaxation etc 6)Do Kegel exercises regularly to strengthen your pelvic floor 7)Try to avoid smoking Hope that helps