Women often feel confused when choosing HRT alternatives to manage their menopause symptoms. Many treatments still lack solid evidence about their effectiveness and safety . Research continues on alternative preparations, but these options usually provide only 50-60% symptom relief compared to traditional HRT's 80-90% effectiveness . Many women still look for non-hormonal approaches because of medical restrictions or personal choice.
Women learning about alternatives to HRT will find some promising options backed by evidence. Research shows that physically active women experience fewer menopausal symptoms . Regular aerobic exercise helps improve psychological health and enhances quality of life for women who experience vasomotor symptoms . Scientists have carefully studied non-HRT treatments like phytoestrogen-rich foods and supplements through 30 randomised trials with 2,730 participants to understand their impact on hot flushes and night sweats . Natural HRT alternatives might not work as well as hormone replacement, but they are a great way to get relief for women who can't or don't want to use traditional HRT.
Why some women seek alternatives to HRT
HRT Menopause can ease symptoms effectively, but many women search for other options. Their reasons help explain why HRT alternatives have become increasingly popular over the last few years.
Concerns about side effects and risks
The potential risks of hormone replacement therapy lead many women to look elsewhere. Research shows HRT creates a small but important increase in breast cancer risk. About 5 extra cases occur in every 1,000 women who take combined HRT for 5 years [1]. Studies have also found links between HRT and other health issues:
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Blood clots become more likely, especially when you have tablet forms [1]
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HRT tablets slightly raise stroke risk (patches, gel or spray don't have this effect) [1]
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Some risk exists for ovarian cancer [1]
These risks might seem small, but they make many women explore non-HRT menopause treatment options. Women often avoid HRT because of side effects like headaches, breast tenderness, unexpected vaginal bleeding, nausea, and mood changes [2].
Personal or medical contraindications
Some medical conditions make HRT dangerous or unsuitable. NHS guidance states women should not take HRT if they:
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Have known or suspected oestrogen-dependent cancer [4]
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Experience undiagnosed vaginal bleeding [4]
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Have untreated endometrial hyperplasia [4]
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Have current or previous venous thromboembolism [4]
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Have active or recent arterial thromboembolic disease [4]
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Have active liver disease with abnormal liver function tests [4]
Women with these conditions must find alternatives to HRT to manage their hot flushes and other symptoms.
Preference for natural or non-hormonal options
Many women see natural approaches as better ways to manage menopause symptoms. They often believe natural remedies bring fewer risks and side effects [5].
The word "natural" can mislead people. Standard HRT hormones often come from natural sources but undergo strict regulation and research to ensure safety and effectiveness [6]. Most complementary medicines labelled "natural" haven't gone through such thorough testing [5].
The appeal of natural HRT alternatives stays strong all the same. Some women choose options like CBT for menopause, acupuncture for menopause, dietary changes, or exercise during menopause.
Women dealing with vaginal dryness might find targeted non-hormonal treatments helpful without systemic hormone therapy's perceived risks. Those experiencing [anxiety and menopause](https://goldmanlaboratories.com/blogs/blog/anxiety_and_menopause) often prefer psychological approaches to hormonal treatments.
Medical necessity, personal values, and risk perception shape the decision to seek alternatives. This makes personalised advice vital when choosing menopause treatment options.
Lifestyle changes that can ease menopause symptoms
Image Source: Wellness OBGYN
Lifestyle changes are a great way to manage menopause symptoms without HRT. Research shows that better eating habits and more physical activity can ease discomfort [7]. These approaches work well as alternatives to HRT.
Exercise and physical activity
Exercise during menopause stands out as one of the best HRT alternatives. The NHS suggests 150-200 minutes of moderate aerobic activity or 75 minutes of vigorous exercise each week [8]. You should also do strength training twice weekly to keep your muscles and bones strong [7].
Three exercise types help women during perimenopause and menopause: strength training, aerobic workouts, and restorative activities [9]. Walking, dancing, and running support bone health, while resistance training helps curb muscle loss as you age [8]. Swimming and cycling are excellent options if your joints hurt [1].
Dietary adjustments
A whole food-based diet for menopause helps ease symptoms. Women who eat more wholegrains, fruits, and vegetables while cutting back on fat see fewer hot flushes. The effects are even better when they lose weight [7].
Starting your day with protein helps you feel full and keeps your metabolism steady [10]. Your body needs 30g of fibre daily for good gut health and weight control [10]. Eating calcium-rich foods like leafy greens, dairy, and bony fish helps protect your bones [8].
Foods rich in phytoestrogens such as soy, flaxseed, and pulses might ease menopausal symptoms [7]. Experts say eating 30 different plant foods each week keeps your gut healthy [7].
Reducing alcohol and caffeine
Alcohol and caffeine can make night sweats and hot flushes worse. Doctors suggest limiting yourself to one drink daily [11]. The NHS recommends no more than 14 units weekly and taking several alcohol-free days [1].
Cutting back on coffee, tea, and other caffeinated drinks—especially before bed—might improve your Sleep After Menopause [1]. Try switching to decaf options or herbal teas instead [1].
Weight management
Weight gain during menopause often starts during perimenopause. Women typically gain about 1.5 pounds yearly through their 50s [2]. Hot flushes happen more often and feel worse if you're overweight [1].
Your 50s might need about 200 fewer daily calories than your 30s and 40s to maintain weight [2]. Choose nutrient-rich foods over processed ones that can lead to insulin resistance and overeating [10].
Diet changes work better when paired with regular exercise [7]. This combined approach not only eases current symptoms but also lowers your risk of long-term health issues linked to menopause.
Cognitive Behavioural Therapy (CBT) and psychological support
Cognitive Behavioural Therapy (CBT) is a proven non-HRT menopause treatment that NICE guidelines recommend among other options or as an alternative to hormone therapy. This therapy helps women understand how their thoughts, emotions, physical reactions, and behaviours connect, and gives them practical ways to handle menopausal symptoms.
How CBT helps with hot flushes and mood
Studies with over 600 women showed CBT reduces how much hot flushes and night sweats affect daily life by a lot. Women also saw improvements in their mood and quality of life [12]. CBT works by helping women challenge negative thoughts that come with menopausal symptoms. To name just one example, women who get hot flushes at work might think "everyone's staring at me" or "they'll think I'm past it." These thoughts lead to embarrassment and anxiety that make the physical sensations worse [12].
CBT for menopause gives women several helpful techniques:
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Simple breathing exercises that calm the body
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Ways to spot and change unhelpful thoughts during hot flushes
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New viewpoints about menopause that are more accepting
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Real-world strategies to handle symptoms
CBT gives women tools to tackle both anxiety and menopause symptoms at once, which matters because past depression often predicts mood changes during menopause [13].
Accessing CBT in the UK
The NHS has several ways to get CBT for menopausal symptoms. Women don't need to see their GP first to use NHS talking therapies [14]. This helps because specialist services often have long waiting times [12].
Women looking for menopause-specific CBT can choose from:
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NHS group courses (usually 4-6 sessions)
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Self-help books written by researchers who tested CBT
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Private sessions with therapists trained in menopause care
The British Menopause Society teaches healthcare professionals how to run group CBT sessions for menopause symptoms [12]. When local or online menopause CBT isn't available, women can buy self-help resources like "Living Well Through the Menopause: a self-help guide using cognitive behavioural therapy" [12].
Other psychological therapies
Several psychological approaches besides CBT are good alternatives to HRT. Mindfulness-Based Interventions (MBI) help reduce anxiety and depression just as well as CBT [3].
Other helpful therapies include:
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Acceptance and Commitment Therapy (ACT)
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Psychotherapy and counselling to adapt to changes
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Group counselling that includes marriage support
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Health promotion coaching
UCL researchers looked at 30 studies with 3,501 women from 14 countries. They found that all types of psychological support improved quality of life [3]. CBT turned out to be budget-friendly, needing about 11.8 hours of treatment total [3].
These psychological approaches are great options for women seeking natural remedies for menopause without medication. They have few side effects and fit well into a comprehensive plan for managing symptoms.
Non-hormonal medications: SSRIs and SNRIs
Selective Serotonin Reuptake Inhibitors (SSRIs) and Serotonin-Noradrenaline Reuptake Inhibitors (SNRIs) are proven medications that help manage hot flushes when HRT Menopause isn't suitable or desired. These medications can reduce vasomotor symptoms by 10-65% compared to placebo [4].
How they work for hot flushes
These medications work by interacting with the body's temperature control system. The brain's temperature control centre becomes disrupted when oestrogen levels drop during menopause [6]. Oestrogen plays a key role by increasing receptor density in tissues and boosting serum serotonin levels [6].
The brain's thermoregulatory "comfort zone" becomes narrow as oestrogen declines. Even small temperature changes of 0.8°C can trigger hot flushes and night sweats [6]. SSRIs and SNRIs help by increasing serotonin availability in the synapse. SNRIs also boost norepinephrine levels to stabilise temperature regulation more effectively [6].
Common options: venlafaxine, paroxetine
Paroxetine is the only SSRI that has formal approval to treat vasomotor symptoms. It comes as a low-dose 7.5mg tablet [5]. Research shows that paroxetine can reduce hot flush frequency by up to 64% [4].
Venlafaxine, an SNRI, works just as well. It reduces hot flush episodes by 40-50% within eight weeks, and patients often see benefits after just two weeks [15]. A daily dose of 75mg venlafaxine cuts down hot flush frequency by about 1.8 episodes more than placebo [15]. Other helpful medications include:
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SSRIs: Citalopram, escitalopram (10-20mg), fluoxetine, sertraline
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SNRIs: Desvenlafaxine (50-150mg), which reduces frequency by 60-65% [6]
Studies comparing venlafaxine with traditional menopause treatment show it reduces vasomotor symptoms by 48%, while estradiol achieves 53% reduction [6].
Side effects and considerations
Patients might experience temporary nausea, dry mouth, drowsiness, dizziness, and sexual dysfunction at first [4]. These effects usually go away within 1-2 weeks [15].
Doctors prescribe lower doses to treat menopausal symptoms than they do for depression [16]. Women taking tamoxifen for breast cancer should avoid paroxetine and fluoxetine. These drugs block the CYP2D6 enzyme needed for tamoxifen to work [4]. Venlafaxine and desvenlafaxine are safer options for these patients [6].
Blood pressure monitoring becomes important with SNRIs, especially for patients with hypertension [4]. Patients should never stop these medications suddenly. A gradual reduction prevents withdrawal effects like "electric-shock" sensations and anxiety [15].
These medications are a great way to get relief for women seeking non-HRT menopause treatment. They help with both vasomotor symptoms and related anxiety and menopause issues, particularly when other alternatives to HRT don't provide enough relief.
Gabapentin and clonidine as HRT alternatives
Some medications that doctors created for other conditions are a great way to get HRT alternatives. Gabapentin and clonidine stand out as good choices for women who deal with troublesome vasomotor symptoms.
Gabapentin: effectiveness and side effects
Doctors first approved gabapentin to treat seizures and nerve pain. Now it has become a reliable option to reduce hot flushes. The North American Menopause Society suggests gabapentin for women who can't or don't want to take oestrogen-containing supplements [8].
Taking 300 mg daily reduces hot flushes by a lot, and it works about as well as oestrogen therapy [8]. Most women start seeing improvements within 4 weeks of regular use [9].
The side effects depend on the dose and include:
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Stomach discomfort
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Drowsiness and dizziness
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Fatigue
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Swelling in the limbs [9]
These side effects are usually mild and don't last long. Women notice them most during the first few weeks [17]. Notwithstanding that, some rare but serious effects can include depression and suicidal thoughts, so doctors need to monitor patients carefully [9].
Clonidine: benefits and limitations
Clonidine helps treat high blood pressure and prevents migraines. UK doctors can prescribe it specifically for menopausal hot flushes - one of the few non-hormonal medications with this approval [18]. This medication works by lowering noradrenaline activity in blood vessels, which helps reduce vasomotor symptoms [7].
Doctors usually start with 25 mcg twice daily, and might increase it up to 50 mcg three times daily [14]. About 40% of women see improvement with clonidine [1], though studies show other medications might work better [19].
Clonidine comes with some drawbacks. Half of all patients experience sleep problems [1]. Other side effects include:
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Constipation and dry mouth
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Dizziness and headache
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Nausea and fatigue
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Depression [18]
Patients need to stop taking clonidine gradually to avoid rebound high blood pressure [18].
When these are recommended
The NHS lists both medications as options to manage night sweats and hot flushes [20]. These medications make sense:
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When hormone therapy isn't safe or possible
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For women who still have symptoms after trying other menopause treatment approaches
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As options for breast cancer survivors and women with specific medical restrictions
NICE guidelines suggest not using clonidine as the first treatment for vasomotor symptoms alone [7]. Gabapentin at 300 mg/day works well for women who can't use hormone therapy or whose hot flushes don't respond to other treatments [8].
Women should have a detailed talk with their healthcare providers about benefits, side effects, and monitoring. This helps ensure they get the best treatment for their specific situation.
Vaginal moisturisers and lubricants for dryness
Vaginal moisturisers and lubricants are a great way to get relief from vaginal dryness - one of the most uncomfortable changes during menopause. About half of all women deal with vaginal atrophy symptoms when their oestrogen levels drop and vaginal cells lose moisture [21].
How they differ from hormonal treatments
HRT Menopause treatments work throughout the body by replacing lost hormones. Moisturisers and lubricants work differently - they only treat the area directly without changing hormone levels. This makes them perfect for women who can't use hormone therapies, including breast cancer survivors [22].
While hormone treatments tackle why it happens by putting oestrogen back into vaginal tissues, moisturisers and lubricants target the symptoms right away [23]. They work well either with vaginal oestrogen treatments or as alternatives to HRT on their own [11].
Prescribable options in the UK
The NHS used to cover certain vaginal moisturisers on prescription. These days, the NHS says people should buy most vaginal moisturisers and lubricants themselves since they're now called "Self Care Medicine" [11]. After Sylk's recall in March 2023, doctors now suggest YES Vaginal Moisturiser for patients who used Sylk before [24].
Over-the-counter choices
You'll find two main types that help with different aspects of vaginal dryness:
Vaginal moisturisers give daily relief that can last up to three days per use [25]. They get absorbed into the skin and lock moisture into vaginal tissue [26]. Popular UK brands include:
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Replens MD - use every three days, with 12 applications in a month's supply [25]
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YES VM - The Menopause Charity backs this as an effective option [27]
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Regelle - another trusted brand for regular use [27]
Vaginal lubricants help make sex more comfortable by reducing friction [2]. These water-based or silicone-based products include:
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Sylk - works both as lubricant and moisturiser [27]
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YES WB (water-based) - safe to use with condoms [11]
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Astroglide - easy to find in stores [2]
Healthcare professionals often suggest using both types of products to manage symptoms better. Moisturisers help with daily comfort while lubricants work best right before sex [23]. These non-HRT menopause treatment options can improve your quality of life and intimate relationships during menopause by a lot.
Phytoestrogens: soy, flaxseed and red clover
Many women look for alternatives to HRT by turning to plant-based compounds that act like oestrogen in the body. These substances have become popular as natural remedies for menopause. The scientific evidence helps us learn about how well they work.
What are phytoestrogens?
Phytoestrogens are natural plant compounds that look structurally similar to human oestrogen [10]. These compounds bind to the body's oestrogen receptors and create either oestrogenic or anti-oestrogenic effects based on existing hormone levels [28]. The body's natural oestradiol binds more strongly to receptors than phytoestrogens [12]. These compounds can still affect hormone-related processes. You'll find several types including isoflavones from soy, lignans from flaxseeds and grains, stilbenes, and coumestans [12].
Food sources and supplements
Here are the best dietary sources of phytoestrogens:
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Soy products - Tofu, tempeh, miso, soy milk and edamame have high levels of isoflavones, especially genistein and daidzein [10]
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Flaxseeds - These pack the most lignans, another key phytoestrogen class [29]
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Red clover - This contains more isoflavones called formononetin and biochanin A than soy [30]
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Other sources - Legumes, whole grains, berries, fruits, and vegetables [31]
You can also find phytoestrogen supplements with concentrated extracts from Red Clover Menopause products or soy isoflavones [32].
Evidence of effectiveness
Research reveals phytoestrogens might help reduce menopausal symptoms, though the effects are modest. Meta-analyses show phytoestrogens substantially reduce hot flushes compared to placebo [28]. Women who took 40mg of soy isoflavones twice daily for 12 weeks saw their hot flashes decrease by 33-42.5% during perimenopause and postmenopause [31].
Research on bone health shows mixed results. Some studies indicate postmenopausal women who eat lots of soy foods have better femoral and lumbar spine density [10]. Other studies found minimal benefits to prevent osteoporosis [10].
Safety concerns for certain women
Most women tolerate phytoestrogens well, with mild stomach issues being the most common side effect [12]. In spite of that, some groups should be careful:
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Pregnant or breastfeeding women should stay away from phytoestrogen supplements [12]
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Women with hormone-sensitive cancers need to talk to their healthcare providers [12]
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Professional guidance becomes essential if you take tamoxifen due to possible interactions [32]
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Your thyroid function might need monitoring if you have thyroid conditions [31]
Menopause supplements with phytoestrogens don't get FDA approval or monitoring for quality and dosage [13]. This makes careful product selection crucial.
Herbal remedies with some supporting evidence
Image Source: Amazon.com
Scientific evidence supports several herbal preparations as natural HRT alternatives. These botanicals provide relief for women who want gentler ways to manage their symptoms, compared to pharmaceutical options.
Black cohosh
Black Cohosh Menopause remedies come from the buttercup family plant Actaea racemosa, native to North America. Scientists still debate how it relieves hot flushes. The relief might come through brain-related actions like serotonin changes, antioxidant effects, or selective oestrogen receptor activity [33].
Clinical trials have produced mixed results. A 2012 Cochrane Review looked at 16 randomised trials and found "insufficient evidence" to support or oppose black cohosh for menopausal symptoms [34]. The North American Menopause Society tells clinicians not to recommend it because it's "unlikely to be beneficial" [33].
St John's Wort
This yellow-flowered plant (Hypericum perforatum) serves as both an antidepressant and possible menopause remedy. It helps by blocking serotonin, dopamine, and norepinephrine reuptake while acting as a potential phytoestrogen [35].
Research suggests St John's Wort can improve menopause-specific quality of life, sleep, and hot flushes [36]. These benefits make it useful for treating both mood changes and physical symptoms.
Dong quai and ginseng
Chinese medicine practitioners have long used dong quai (Angelica sinensis). As a standalone treatment, it shows limited benefits but might help when combined with other herbs [36]. Laboratory studies reveal dong quai extracts have antitumor, neuroprotective, and hematopoietic effects beyond menopause [37].
Ginseng focuses on quality of life issues rather than vasomotor symptoms. Research hasn't found it better than placebo for hot flushes [36]. However, some studies suggest it might help with sexual dysfunction during menopause [38].
Safety and regulation in the UK
Experts recommend looking for the Traditional Herbal Remedy (THR) logo to confirm strength and quality when choosing herbal treatments [14]. This regulatory stamp gives you simple safety standards.
"Natural" doesn't always mean "safe." Herbal remedies can cause serious side effects or interact with medications. St John's Wort interacts with many drugs including contraceptives, antidepressants, and tamoxifen [39]. Women taking other medications should be careful.
Mind-body therapies: acupuncture, yoga and more
Image Source: Healthline
Mind-body approaches have become promising alternatives to HRT for women who want relief from menopausal symptoms without medication.
Acupuncture: what the studies say
Research into [acupuncture for menopause](https://goldmanlaboratories.com/blogs/blog/acupuncture-for-menopause) reveals impressive results. A meta-analysis of 12 randomised controlled trials showed that acupuncture substantially improves vasomotor symptom frequency and severity, and these benefits last up to three months [40]. The improvements continue for at least six months after treatment ends [40].
Women start seeing benefits after just three acupuncture sessions, with best results showing up after about eight treatments [40]. A study found a substantial decrease in hot flushes (Δ −1.6) after six weeks, along with better sleep, improved emotional symptoms, and less physical discomfort [41]. About 80% of women reported positive effects [41].
Yoga and relaxation techniques
Exercise during menopause through yoga brings substantial relief to many women. Specific breathing techniques like Sitali (inhaling through a rolled tongue) and Chandra Bhedana (left-nostril breathing) cool the body and calm the mind effectively [42].
Women who experience anxiety and menopause symptoms can find quick relief through grounding techniques like Earth Mudra—touching the thumb's tip to the ring finger [42]. A 3:5 breathing ratio activates the parasympathetic nervous system and encourages deeper calm [42].
Studies confirm that 60-minute yoga sessions twice weekly for 10 weeks reduce psychological, somatic, and urogenital symptoms [43].
Reflexology and hypnotherapy
Reflexology works on specific points on the feet that connect to different body parts. Clients report less stress, better Sleep After Menopause, fewer hot flushes, and improved emotional balance [3].
Hypnotherapy stands out among these natural remedies for menopause. A clinical trial with 187 post-menopausal women showed that five weekly hypnosis sessions cut hot flushes by 80% [44]. Sleep quality improved in 50-77% of participants [44], and the treatment helped manage mood swings and emotional challenges effectively [44].
Emerging and less common options
New and promising therapies have emerged as HRT alternatives for women who want relief from menopausal symptoms.
Stellate ganglion block
Stellate ganglion block (SGB) is a procedure where doctors inject local anaesthetic into sympathetic ganglia in the neck using ultrasound or fluoroscopic guidance. The treatment shows excellent results for vasomotor symptoms, particularly helping breast cancer survivors who cannot take HRT Menopause treatments.
Research proves that SGB reduces moderate to severe hot flushes by 52% while control groups only saw 4% improvement [45]. The benefits usually last six months after the procedure [46]. Patients rarely experience side effects (1.7 per 1,000 procedures) [45]. When side effects occur, they typically include temporary hoarseness and dizziness.
Homoeopathy
Homoeopathy works with highly diluted substances based on the "like cures like" principle. Practitioners believe these preparations help activate the body's natural healing abilities. A recent observational study revealed that 99% of women noticed their symptoms reduced or disappeared within 15 days of homoeopathic treatment [47].
Women often use Lachesis for night sweats and emotional intensity. Sepia helps with fatigue and low libido, while Belladonna provides relief from intense hot flushes [48].
Magnet therapy and others
Magnet therapy products claim they can restore balance to the autonomic nervous system and reduce menopause symptoms. The scientific evidence supporting these claims remains nowhere near sufficient [4]. Manufacturers say magnets help with various symptoms—from anxiety and menopause to vaginal dryness. However, experts conclude there's "little reason to believe magnets can have any effect" [4].
Who should avoid HRT and consider alternatives
Some medical conditions make HRT Menopause impossible. Women with these conditions need to learn about alternatives to HRT.
Breast cancer survivors
Women with breast cancer diagnoses should not take HRT [49]. Doctors remain uncertain whether hormone therapy could increase cancer recurrence. These cancer survivors can choose non-HRT menopause treatment options such as:
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Exercise During Menopause and lifestyle changes
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Non-hormonal medicines that help with Hot Flushes
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Treatments applied directly to help with Vaginal Dryness
Specialist menopause clinics can create personalised treatment plans [49].
Women with clotting disorders
Blood clot risks increase with HRT tablets [50]. This makes them dangerous for women who have had blood clots or clotting disorders. Patches, gels, or sprays applied to the skin are safer options because they don't raise clotting risks [51]. Women's VTE risk multiplies 25 times with oral oestrogen if they have Factor V Leiden, so they must avoid it [52].
Other medical contraindications
Natural Remedies for Menopause are needed when women have:
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Liver disease showing abnormal function tests [52]
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Unexplained vaginal bleeding
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Recent blood clots in arteries
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Cancers that grow with oestrogen
Conclusion
Managing menopause without HRT Menopause treatment needs a personal approach that depends on your symptoms and medical history. Non-hormonal options usually reduce symptoms by 50-60%, while traditional hormone therapy provides 80-90% relief. These alternatives are a great way to get help for women who can't or don't want to use hormonal treatments.
Research shows that lifestyle changes work best as initial strategies. A balanced Diet for Menopause and regular Exercise During Menopause can reduce symptoms by a lot while boosting overall health. CBT for Menopause shows great results in handling both physical and emotional challenges.
Women looking for medicine-based options can try non-hormonal medications such as SSRIs, SNRIs, gabapentin, or clonidine. These work especially well with Hot Flushes and Night Sweats when hormones aren't an option.
Targeted treatments can help with specific symptoms. Vaginal moisturisers and lubricants help with Vaginal Dryness without affecting the whole body. This makes them safe for women who can't use hormone therapy.
Plant-based solutions show promise too. Phytoestrogens found in soy products, flaxseeds, and Red Clover Menopause supplements can reduce hot flashes mildly. Black Cohosh Menopause and Sage for Menopause results vary, but they remain popular Natural Remedies for Menopause choices.
Mind-body therapies deserve attention. Acupuncture for Menopause shows strong clinical results. Yoga and mindfulness help manage physical discomfort and Anxiety and Menopause symptoms at the same time.
Some women must use these alternatives because of health reasons. Breast cancer survivors, women with clotting disorders, and those with specific health issues should work with their healthcare providers to create safe symptom management plans without hormones.
Doctors suggest a step-by-step approach to Menopause Treatment. Start with lifestyle changes, add Menopause Supplements or mind-body therapies if needed, then try non-hormonal medications for stubborn symptoms. This approach often brings relief without using hormones.
Menopause is a natural life change, not a medical condition that needs the same treatment for everyone. While HRT works best for many women, these proven alternatives help manage symptoms from Weight Gain During Menopause to disrupted Sleep After Menopause. The best approach combines what works, what's safe, and what fits your health needs—giving you the ability to handle this transition in your own way.
Key Takeaways
While HRT alternatives typically provide 50-60% symptom reduction compared to 80-90% from hormone therapy, they offer valuable options for women who cannot or prefer not to use traditional treatments.
• Lifestyle changes are first-line treatments: Regular exercise, balanced diet, and reducing alcohol/caffeine can significantly ease menopause symptoms naturally.
• CBT proves highly effective: Cognitive Behavioural Therapy reduces hot flush impact by challenging negative thought patterns and teaching practical coping strategies.
• Non-hormonal medications work: SSRIs, SNRIs, gabapentin, and clonidine can reduce hot flushes by 10-65% compared to placebo.
• Local treatments address specific symptoms: Vaginal moisturisers and lubricants effectively manage dryness without systemic hormone effects.
• Mind-body therapies show promise: Acupuncture reduces vasomotor symptoms significantly, whilst yoga and hypnotherapy improve multiple menopause-related concerns.
A tiered approach works best—starting with lifestyle modifications, adding supplements or therapies as needed, then considering medications for persistent symptoms. This layered strategy often provides satisfactory relief whilst allowing women to maintain control over their treatment choices during this natural transition.
FAQs
Q1. What are some effective alternatives to HRT for managing menopause symptoms? Several evidence-based options include lifestyle changes like regular exercise and a balanced diet, cognitive behavioural therapy (CBT), non-hormonal medications such as SSRIs and gabapentin, and mind-body therapies like acupuncture and yoga. These alternatives can provide significant relief, though typically not as comprehensive as HRT.
Q2. Are there natural remedies that can help with menopausal hot flushes? Yes, some natural remedies show promise for managing hot flushes. These include phytoestrogen-rich foods like soy and flaxseed, herbal supplements such as black cohosh, and relaxation techniques like yoga and mindfulness. However, their effectiveness can vary, and it's important to consult a healthcare provider before starting any new treatment.
Q3. How effective is cognitive behavioural therapy (CBT) for menopause symptoms? CBT has shown impressive results for managing menopausal symptoms, particularly hot flushes and mood changes. Research indicates that CBT can significantly reduce the impact of hot flushes and improve overall quality of life. It works by helping women challenge negative thought patterns and develop practical coping strategies.
Q4. What options are available for women who can't use HRT due to medical reasons? Women with contraindications to HRT have several options. These include non-hormonal medications like SSRIs or gabapentin for hot flushes, vaginal moisturisers for dryness, and lifestyle modifications. Mind-body therapies such as acupuncture and hypnotherapy have also shown benefits. It's crucial to work closely with a healthcare provider to develop a personalised treatment plan.
Q5. Can dietary changes help manage menopause symptoms? Yes, dietary adjustments can play a significant role in managing menopause symptoms. Increasing intake of whole grains, fruits, and vegetables while reducing fat consumption has been shown to moderately reduce hot flushes. Foods rich in phytoestrogens, like soy products and flaxseeds, may also offer some relief. Additionally, limiting alcohol and caffeine can help improve sleep and reduce hot flushes.
References
[1] - https://gpnotebook.com/en-GB/pages/gynaecology/clonidine-in-the-treatment-of-menopausal-symptoms
[2] - https://www.mayoclinic.org/diseases-conditions/menopause/expert-answers/vaginal-dryness/faq-20115086
[3] - https://www.baileypodiatry.co.uk/blog/can-reflexology-really-help-with-menopause
[4] - https://www.healthline.com/health/menopause/magnets-for-menopause
[5] - https://www.facingourrisk.org/info/risk-management-and-treatment/menopause-management-without-hormones
[6] - https://pmc.ncbi.nlm.nih.gov/articles/PMC10870088/
[7] - https://www.drlouisenewson.co.uk/knowledge/clonidine-for-hot-flushes
[8] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4076904/
[9] - https://www.medicalnewstoday.com/articles/gabapentin-for-hot-flashes
[10] - https://pmc.ncbi.nlm.nih.gov/articles/PMC3074428/
[11] - https://www.bswformulary.nhs.uk/chaptersSubDetails.asp?FormularySectionID=7&SubSectionRef=07.02&SubSectionID=A100
[12] - https://www.drlouisenewson.co.uk/knowledge/phytoestrogen-supplements
[13] - https://www.healthline.com/health/phytoestrogens
[14] - https://thebms.org.uk/wp-content/uploads/2025/11/04-BMS-ConsensusStatement-Non-hormonal-based-treatments-for-menopausal-symptoms-NOV2025-C.pdf
[15] - https://www.menopausespecialists.com/post/venlafaxine-for-menopausal-symptoms
[16] - https://www.menopause.org.au/hp/information-sheets/nonhormonal-treatments-for-menopausal-symptoms
[17] - https://www.kemh.health.wa.gov.au/~/media/HSPs/NMHS/Hospitals/WNHS/Documents/Patients-resources/Menopausal-Symptoms---Gabapentin.pdf
[18] - https://birminghammenopauseclinic.com/treatments/non-hrt-treatment-2/
[19] - https://www.nhs.uk/medicines/clonidine/common-questions-about-clonidine/
[20] - https://www.nhs.uk/conditions/menopause/treatment/
[21] - https://www.londonwomenscentre.co.uk/our-treatments/vaginal-atrophy
[22] - https://www.ruh.nhs.uk/patients/patient_information/BRU028_Vaginal_dryness_and_breast_cancer.pdf
[23] - https://www.nhs.uk/symptoms/vaginal-dryness/
[24] - https://thebms.org.uk/2023/08/availability-of-sylk-intimate-lubricant-and-the-alternative-for-prescribers/
[25] - https://well.co.uk/replens-vaginal-moisturiser-35g/?srsltid=AfmBOoo_AgL_gtcva5zyqNscb9wCKLKFYE2DaNsp5rnTSs_aymGfA7nc
[26] - https://www.breastcancer.org/treatment-side-effects/vaginal-dryness/moisturisers-lubricants
[27] - https://themenopausecharity.org/information-and-support/symptoms/vaginal-dryness/
[28] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4389700/
[29] - https://www.nutritionist-resource.org.uk/articles/phytoestrogens-in-perimenopause-pros-and-cons
[30] - https://pmc.ncbi.nlm.nih.gov/articles/PMC1780039/
[31] - https://www.medicalnewstoday.com/articles/320630
[32] - https://www.drlouisenewson.co.uk/knowledge/isoflavones-can-red-clover-supplements-help-me
[33] - https://ods.od.nih.gov/factsheets/BlackCohosh-HealthProfessional/
[34] - https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD007244.pub2/abstract
[35] - https://www.drlouisenewson.co.uk/knowledge/st-johns-wort-for-menopause-symptoms
[36] - https://www.rcog.org.uk/media/gwbntgdu/sip_6.pdf
[37] - https://www.mskcc.org/cancer-care/integrative-medicine/herbs/dong-quai
[38] - https://www.menopausecare.co.uk/blog/herbal-remedies-for-menopause
[39] - https://www.mayoclinic.org/drugs-supplements-st-johns-wort/art-20362212
[40] - https://pmc.ncbi.nlm.nih.gov/articles/PMC4874921/
[41] - https://bmjopen.bmj.com/content/9/1/e023637
[42] - https://bwy.org.uk/how-yoga-can-support-women-through-menopause-and-beyond/
[43] - https://www.amh.org.uk/how-yoga-can-help-during-the-menopause/
[44] - https://www.menopausecare.co.uk/blog/hypnotherapy-for-menopause
[45] - https://www.ccjm.org/content/89/3/147
[46] - https://womensmentalhealth.org/posts/stellate-ganglion-blockade-vasomotor-symptoms/
[47] - https://www.positivepause.co.uk/menopause-blog/homoeopathy-menopause-treatment-relieve-symptoms-naturally
[48] - https://purehealingwithhomeopathy.com/2024/05/19/easing-the-transition-homoeopathic-support-for-perimenopause-and-menopause/
[49] - https://breastcancernow.org/about-breast-cancer/awareness/breast-cancer-risk-factors-and-causes/hormone-replacement-therapy-hrt-and-breast-cancer-risk
[50] - https://www.nhs.uk/medicines/hormone-replacement-therapy-hrt/benefits-and-risks-of-hormone-replacement-therapy-hrt/
[51] - https://www.drlouisenewson.co.uk/knowledge/blood-clot-and-hrt-what-you-need-to-know
[52] - https://themenopausecharity.org/information-and-support/living-with-other-conditions/menopause-and-clots/
