Menopause (sage) has no significant impact on hormones levels; it works more on the sweating reaction and this is why it is also safe for men. However, this means that the product mainly calms the symptoms without necessarily treating the hormonal imbalance causing hot flashes.
Usually, women will need to take Menopause until the hormones naturally adjust. For some women this can take a few months, but for others it takes a few years. Worst case scenario, the hot flashes do not go away unless something is done to support the hormonal levels.
We must pay a lot of attention to supporting the adrenal system during menopause. I would suggest a good multivitamin and mineral supplement, extra magnesium such as Salus Haus liquid magnesium and a herbal stress remedy such as Passion Flower.