At age 54 then you would be of the right age for a natural menopause. I would suggest that you start to gradually wean yourself off HRT by halving the strength for a period of six months then change to alternate nights for a while before stopping..
Natural remedies to reduce night sweats include black cohosh, agnus castus and evening primrose oil. These have not been proven in clinical trials but many women say that they help.
I appreciate that hot flashes are unpleasant, and can often require changing the bedding however with time your body will get used to the reduction in hormones. Using layered bedding allows you to take layers on and off as required.
You cannot cut them in half due to the coating, I do not know whether taking on alternate days would be sufficient without a period on the lower strength tablets.
Evening primrose is usually 500mg two a day. but your local drugstore will usually keep specific products for the menopause
The risks of HRT include a theoretical risk of breast cancer, and an increase in deep vein thrombosis. The lack of uterus removes the risk of endometrial cancer. Current recommendations is that HRT should be reviewed after 5-10 years of continual use.
Going through menopause is unpleasant but not risky. Long term you need to keep an eye on your calcium intake and cardiovascular health.
The alternate days is commonly done at the lower strength but trials have not been done at your current strength. The half life is quite long, and so alternate days may be worth trying if you do not want to invest in the lower strength tablets.
Pharmacist
MRPharmS. Worked as Community pharmacist for 16 years. Undertaking a second degree in medicine.