Things to consider

Although hormone replacement therapy (HRT) is considered a safe and effective way to treat perimenopause symptoms, it still carries certain risks.

Because of this, many people have turned to home remedies and other holistic methods to help ease their symptoms.

While some of these therapies are backed by clinical research, many others have only scant or anecdotal evidence to support their use.

Always talk to your doctor or other healthcare provider before you try any alternative treatment. They can discuss possible dosage, side effects, and interactions with you.

When you’re going through perimenopause, you may find that what you eat triggers certain symptoms.

Spiking blood sugar levels, for example, can lead to irritability and zap your energy. Dehydration can lead to increased hot flashes. And eating food high in sodium can make you retain water, making you feel bloated.

You may find that reducing the amount of refined, processed, and preservative-heavy foods in your diet improves how you feel.

Cut down on caffeine, alcohol, and spicy food

Limiting stimulants like coffee and tea may help reduce hot flashes. Spicy food may also contribute to the feeling of heat rising in your body.

Alcohol has been linked to making hot flashes worse, so indulge in moderation or cut it out completely.

Up your intake of calcium and vitamin D

As you age, your risk of osteoporosis increases. Vitamin D, which helps your body absorb calcium, is also essential. Consuming foods rich in calcium and vitamin D won’t just make your bones stronger, but can also boost your mood.

Use caution with soy and other phytoestrogens

There’s a tentative link between menopause symptoms and a high consumption of soy and other plant estrogens. But the research on this is conflicting. You may want to play it safe and limit intake of foods like tofu, edamame, and soy milk.

Exercise can stabilize your blood sugar levels, give you more energy, and boost your mood.

And if you exercise regularly, the benefits increase.

For example, regular exercise can help reduce your risk of osteoporosis and improve your sleep quality in the long term. It can also aid in weight management. That may reduce hot flashes.

For maximum benefit, your exercise routine should include each of these four types of exercise:


Running, taking a spin class, or going for a brisk walk can all reduce your risk of heart disease and help you maintain a healthy weight. This type of exercise also releases mood-boosting endorphins.


Exercise that involves being on your feet preserves bone mass to help prevent osteoporosis. Tennis, stair-climber machines, and dance classes are all great exercises for bone health.


Strengthening exercises, like free weights and resistance bands, add muscle mass to your body, which helps you burn extra calories. This kind of exercise has also been linked to reducing anxiety and improving mental health.


Flexibility exercises include yoga, Pilates, or regular stretching. Flexibility exercises can improve your coordination, making you surer on your feet, and even stave off arthritis.

When you experience stress, your adrenal glands produce adrenaline to power your body through the situation you’re in. And from menopause on, your adrenal glands are also a source of estrogen.

When your adrenal glands are activated too often, they don’t function as well. That leaves your estrogen levels even lower than before. This can exacerbate symptoms like weight gain and difficulty sleeping.

You may not be able to cut stress out of your life completely, but you can learn to manage stress in healthy ways that won’t fatigue your adrenal glands.

Mindfulness meditation

Mindfulness meditation is a stress management technique that focuses on quiet awareness, inner peace, and breathing exercises. It may improve your ability to cope with hot flashes and night sweats.

Cognitive behavioral therapy (CBT)

CBT can help you reframe negative thought patterns into something more positive. One study suggests that CBT can help improve your mood and overall sleep quality. More research is needed, though.

These changes, though small, may have a big impact on how you feel.

Keep your space cool and ventilated

Make sure that spaces you frequent have proper air-conditioning equipment and ventilation in case you need to cool off quickly.

Wear loose clothing

Looser clothing can keep you feeling at ease and make it easier to ventilate your body when a hot flash starts.

Use a vaginal moisturizer for general dryness

If you’re experiencing vaginal dryness, consider purchasing a moisturizer made specifically for the vagina. They can be used throughout the day to help ease itching and irritation.

Use a vaginal lubricant for sexual activity

Vaginal lubricants add wetness to the vagina, which can help prevent discomfort during penetration.

Quit smoking

Smoking cigarettes may have an effect on your fluctuating hormone levels. This can ultimately increase your number of hot flashes.

Some nutrients are crucial for symptom management. If you’re not getting enough of these nutrients in your diet, supplements may be an option.

Supplements aren’t regulated by the U.S. Food and Drug Administration (FDA), so use caution. Only purchase from buyers you trust. Also talk to a healthcare provider before adding any supplement to your routine.

B vitamins

B vitamins regulate energy and help your body produce new cells. These vitamins, especially folic acid, may help reduce the length and severity of hot flashes. Just 1 milligram (mg) of folic acid per day can be effective.

Vitamin E

Vitamin E helps your body neutralize oxidative stress. Vitamin E in a dose of up to 360 mg per day may improve hot flashes by up to 40 percent.

Vitamin D

Vitamin D maintains your bone structure, helps you absorb calcium, and may improve hormone regulation and vaginal dryness. Take 10 to 20 micrograms of vitamin D per day to lower your osteoporosis risk and improve your mood.


Omega-3 fatty acids may help lubricate your body, helping with vaginal dryness. When taken in addition to SSRIs, omega-3 supplements may also improve depression.

Some herbal supplements claim to help manage perimenopause and menopause symptoms. It’s important to remember that the FDA doesn’t regulate supplements. Research on use is often shaky at best.

You should always talk to a healthcare provider before adding a supplement to your routine. Dosing guidelines vary widely. Some products may also interact with over-the-counter and prescription medication.

Black cohosh

Black cohosh is a flowering plant that may work to balance hormones. Taking one 40-mg dose per day may help decrease hot flashes.

St. John’s wort

St. John’s wort is a yellow flowering plant that may improve your sleep quality during and after menopause. Older research suggests that taking 900 mg per day may be effective.

Dong quai

Dong quai is an herb used in traditional Chinese medicine. Dong quai may act like estrogen in your body, balancing your hormones during menopause.

Chaste tree

Chaste tree is a shrub that produces berries used in herbal preparations. Chaste tree berry may have hormone-balancing effects. Researchers are still unsure how it can impact menopause symptoms, though.


Prepared from the maca plant, this herb may help balance hormone levels and improve sexual function.

Red clover

Red clover contains isoflavones. These can act like estrogen in your body. Some research suggests that taking 82 mg per day may help relieve hot flashes.


Some research suggests that taking a daily tablet of fresh sage can help minimize hot flashes and improve other menopause symptoms.

Milk thistle

Milk thistle contains isoflavones. They may also help balance your hormones. Milk thistle may also help prevent osteoporosis.

Valerian root and hops

Valerian root and hops are both herbal sleep aids. Valerian root, in particular, is widely regarded as an effective treatment for insomnia.

At least one study showed valerian root and hops to be better than placebo at reducing sleep disturbances and other menopause symptoms when taken together.

Evening primrose oil

Evening primrose oil is high in fatty acids that may help keep your body lubricated. However, more research is needed to understand how it may or may not be of use.


Ginseng may help boost your mood. However, it’s unlikely to have an effect on other symptoms.


Licorice may help keep your adrenal system from becoming fatigued. Some research also suggests that licorice supplementation can decrease hot flashes and night sweats.

Some people turn to alternative therapies to help with symptom management. These therapies have both been found to have some degree of success in treating menopause symptoms.


Acupuncture is performed by a certified specialist who inserts tiny needles into pressure points on your body. Acupuncture has been found to decrease the intensity and frequency of hot flashes in people experiencing menopause.

Tai chi

Tai chi is an exercise that’s part meditation and part slow, dancelike motion. Tai chi may help reduce night sweats and hot flashes when practiced for at least one hour, twice per week.

HRT isn’t your only option for clinical treatment. These medications may also help improve your symptoms.

Antidepressants (SSRI and SNRI)

Certain antidepressant medications are prescribed to treat hot flashes and other symptoms.


Clonidine (Catapres) is a blood pressure medication. It causes your blood vessels to dilate. This may reduce hot flashes and night sweats.


Gabapentin (Neurontin) is a drug often prescribed for pain relief and seizures. It may also help reduce hot flashes.

Bioidentical hormones are made in a lab from chemicals found in plants. They’re said to be more similar to hormones your body naturally produces than those used in HRT.

Researchers are still working to figure out if bioidentical hormones are a safe and effective way to treat menopause symptoms.

These supplements haven’t been rigorously tested on humans, so they could pose long-term health risks we don’t know about yet. As of now, there’s no evidence to suggest these are safer or more effective than traditional HRT.

If you’re interested in bioidentical hormones, talk to a doctor. They can discuss your options and may be able to prescribe an appropriate pill, patch, or cream.

If you’re considering any of the above therapies, work with a doctor or other healthcare provider to make a treatment plan. They can help you assess your individual benefit and risk level as well as advise you on dosage.