If we’re lucky humans with a uterus, menopause is a natural part of life. Surprisingly, what many women don’t know about are the unwanted symptoms that often come along with it. Obviously, that needs to change, and I want to be part of that change. However, hot flashes, mood swings, and sleep problems are just a few of the challenges that can affect your quality-of-life. While hormone therapy is a common treatment, it’s not for everyone. That’s why I wanted to put together this practical guide about non-hormonal treatments for menopause for you, straightaway.
Why choose non-hormonal treatments?
There are many reasons you may want to explore non-hormonal treatments. Not surprisingly, many of us want to do things “the natural way,” or avoid putting more things in our system. Then, there is the long list of side effects that can come along with some menopausal treatments. Lest we forget, the study released as part of the Women’s Health Initiative study that scared the hell out of many of us. Thankfully, this has mostly been reversed with the latest studies, but the fear still remains for some people. So given what we know so far, what are some of the reasons womxn may choose to forego HRT?
Medical reasons
Furthermore, some health conditions make hormone therapy risky. For example, women with a history of breast cancer, heart disease, or blood clots may be advised against using hormone therapy.
Personal choice
As mentioned before, you might prefer a more natural approach without relying on pharmaceutical interventions, specifically hormones.
Side effects
Notwithstanding, hormone therapy doesn’t agree with everyone and neither do some of the alternatives. Some women experience side effects such as bloating, breast tenderness, or nausea and the side effects may be worse than the symptoms. I can relate to this, as someone who would rather be nauseous than take any antiemetic drug on the market.
Ultimately, there’s no one-size-fits-all solution. What works for one person might not work for another and it’s important to make health decisions that fit into the context of your life and personal health.
Common menopause symptoms
This isn’t the first time we have talked about menopause here on the Wellspiration blog. We have talked about it here and here, but it warrants a refresh. Before we dive into treatments, let’s do a quick review at the primary symptoms of menopause. According to the North American Menopause Society, common symptoms include:
- Hot flashes and night sweats (vasomotor symptoms)
- Mood changes
- Sleep problems
- Vaginal dryness
- Weight gain
These symptoms can range from mildly annoying to seriously disruptive. The good news is that there are ways to manage them without hormone therapy.
Lifestyle changes: Small steps, big impact
Sometimes, simple changes in your daily routine can make a big difference in how you feel. I know lifestyle changes encompass almost every health topic on Wellspiration, but it’s because they work and impact everything we do.
Diet: You are what you eat
What you put on your plate can affect your menopause symptoms. Here are some tips based on current research:
Try eating phytoestrogens: These are plant compounds that act like estrogen in your body. A systematic review found that consuming soy isoflavones was associated with a modest reduction in hot flashes and night sweats. Incorporating organic and non-gmo soy into your diet may be an easy way to get some symptom relief.
Supplementing calcium and vitamin D: These nutrients are important for bone health, which can be affected during menopause. The National Institutes of Health recommends 1,200 mg of calcium and 600-800 IU of vitamin D daily for women over 50.
Listen to your body: Pay attention to how different foods make you feel. Some women report that spicy foods or alcohol can trigger hot flashes, although more research is needed in this area. Speaking from personal experience, I can attest that alcohol definitely exacerbated symptoms – especially including the insomnia and vasomotor symptoms. Cutting this out gave me dramatic improvement in my symptoms.
Exercise: Move your body
It’s no surprise that regular exercise can help with mood, sleep, and even hot flashes. A Cochrane review found that exercise, particularly aerobic exercise, may improve quality of life and reduce vasomotor symptoms in menopausal women. You don’t need to run a marathon – find activities you enjoy:
- Walking
- Swimming
- Yoga
- Dancing
While the U.S. Department of Health and Human Services recommends about 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity per week, don’t underestimate weights. In fact, strength training may be even more important because it helps prevent bone loss in menopausal women, which is a risk.
Stress management: Keep calm and carry on
Stress can make menopause symptoms worse. A study found that stress reduction techniques can help manage vasomotor symptoms. Try these stress relief techniques:
- Mindfulness and meditation: Take a few minutes each day to sit quietly and focus on your breath.
- Set boundaries: Learn to say no to things that drain your energy.
- Prioritize sleep: Create a bedtime routine that helps you relax.
The alcohol connection
Here’s something you might not expect: cutting back on alcohol can help with menopause symptoms. At least, that’s what my personal experience says. However the risk of alcohol consumption during menopause increases risk of cardiovascular disease, stroke, and other issues. While we don’t really have data specifically linking the relationship between alcohol and increased vasomotor symptoms, it doesn’t mean the link doesn’t exist. If you enjoy a glass of wine with dinner, you don’t have to give it up completely. However, if you enjoy the regular bite of alcohol and experience those notorious menopausal symptoms, experiment with some alcohol-free days or zero proof spirits and see how you feel.
Natural remedies: Nature’s medicine cabinet
Some women find relief from menopause symptoms with herbal supplements and essential oils. Unfortunately, for multiple reasons, there is not a lot of data on things like supplements and herbs, so use caution and work with a trained professional before going down this path. Remember, “natural” doesn’t always mean safe or effective, so use caution and make sure you’re working with your doctor and/or a qualified professional before pursuing the natural remedies. In other words, your local Young Living rep isn’t a qualified professional.
Herbal supplements
As an herbalist, I love using herbs for things like vasomotor symptoms, but it’s important to look at the use of herbs in context. Because not every herb is for every person and just because something has a reputation for being a “menopause herb,” doesn’t mean it’s “your menopause herb,” or that it’s even true. Additionally, depending on how your symptoms present, you could make your symptoms even worse, so buyer beware.
Black cohosh
A systematic review found that black cohosh was associated with a modest reduction in vasomotor symptoms, but noted that more research is needed on its long-term safety. Whereas, the larger issue is that Black Cohosh is contraindicated for several things and if you aren’t doing your research and/or working with a professional, you could make yourself more uncomfortable. The bigger issue is adulterated black cohosh, which can be very harmful, so be sure you have a reputable source. Finally, black cohosh is severely threatened so only buy reliable cultivated sources, or use different herbs.
Red clover
The same review found some evidence for the effectiveness of red clover in reducing hot flashes, but the results were not consistent across all studies. Herbalists love red clover because it’s rich in isoflavlones which we already talked about being helpful for vasomotor symptoms. The risk associated with red clover is because it creates something called dicoumoral, which can thin blood, but that’s becomes an issue when the herb is fermented, so again, know your source to ensure high quality ingredients.
Evening primrose oil
While a review found no significant difference between evening primrose oil and placebo for managing hot flashes, herbalists have been using it for years. Meanwhile, clinically and anecdotally, it has been very effective in easing the symptoms of vaginal dryness and hormonal depression often associated with menopause.
Essential oils
While scientific evidence is limited, some studies suggest essential oils might help you relax and manage some symptoms. Even if the impacts are placebo, if a lavender diffuser in your bedroom at night helps you relax, then why not?
Lavender
Research suggested that lavender aromatherapy might help promote relaxation and improve sleep quality in menopausal women. There’s a reason lavender pillow sprays are so popular and this may be why.
Clary sage
A study found that inhalation of clary sage oil reduced cortisol levels and had an anti-depressant effect in menopausal women. Also, it smells really nice, so why not.
There are very few essential oils that are safe for topical use as-is, so if you insist on putting these directly on your skin, be sure to properly dilute and do a skin test first. Ingesting essential oils can be very dangerous, so again, please consult a doctor before heading in this direction.
Non-hormonal medications: When you need extra help
Sometimes, lifestyle changes and natural remedies aren’t enough. There are several non-hormonal medication options that may be a good fit.
SSRIs and SNRIs
These are usually used for depression, but they can also help with hot flashes and mood swings. A review found that SSRIs and SNRIs can reduce the frequency and severity of hot flashes, as an off-label use. Plus, if hormonal depression is an issue, it may provide dual support.
Gabapentin
Gabapentin is often used for nerve pain and epilepsy, but it might also reduce hot flashes. A study found that gabapentin was effective in reducing hot flash frequency and severity in some patients.
Clonidine
This blood pressure medication might help some women with hot flashes. According to a Cochrane review, clonidine was modestly effective in reducing hot flashes in post-cancer patients, but side effects were common.
Again, talk to your doctor about these options, since in the US, they are only available with a prescription. They can help you weigh the potential benefits and risks and consider the side effects, as there are many possibilities.
Mind-body practices: Train your brain
Your mind’s a powerful tool in managing menopause symptoms and one of my favorite non-hormonal ways to treat menopause. As a matter of fact, a systematic review found that mind-body interventions can be effective in managing vasomotor symptoms. Here are some practices to consider:
Cognitive Behavioral Therapy (CBT)
This type of therapy can help you develop strategies to cope with symptoms and stress. Additionally, CBT can help you adapt and incorporate lifestyle changes to benefit your overall wellbeing.
Mindfulness and meditation
Regular practice can reduce stress and might even help with hot flashes. Breathing techniques are helpful for numerous reasons, but may help reduce the stress associated with vasomotor symptoms, thus reducing the impact of the symptoms.
Yoga and tai chi
These practices combine physical activity with mindfulness, offering multiple benefits. Accordingly, you can build additional strength and flexibility, supporting bone and physical health. All of which, are important for menopausal health.
Finding what works for you
Even so, everyone’s menopause experience is different. Remember, what works for one person might not work for another, so don’t be afraid to try multiple things until you find the right fit. Be patient with yourself and don’t hesitate to explore additional options. After all, you may be surprised what works for you!
Ready for personalized help?
What non-hormonal treatments for menopause are you ready to try? If you’re feeling overwhelmed or just want some guidance, I’m here to help. As someone who’s been through it, I’d love to share my knowledge and save you some headaches. At Pomona Wellness, I incorporate coaching, including lifestyle and behavioral changes, and herbalism, to give clients the support they need. Book a consultation with me, and we can talk about your unique menopause experience. Together, we can create a plan that works for you. Whether that involves lifestyle changes, natural remedies, or other options, we got you covered. Not ready for that? Follow Wellspiration and get regular content on everything to support your wellbeing, or subscribe to our Substack. There, you can find access to personal stories that are more “happy hour” than Monday morning.
Menopause isn’t the end – it’s just a new chapter in your life. Wishing you abundant health and limitless joy!
Medical Disclaimer:
These statements have not been evaluated by the Food and Drug Administration (FDA). Information provided in this blog post is for educational and informational purposes only and should not be considered as medical advice. The content is not intended to be a substitute for professional medical advice, diagnosis, treatment, cure or prevention of any disease. Always seek the advice of your physician or another qualified healthcare provider with any questions you may have regarding a medical condition.
Resources
Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal Hormone Therapy and Health Outcomes During the Intervention and Extended Poststopping Phases of the Women’s Health Initiative Randomized Trials. JAMA. 2013;310(13):1353–1368. doi:10.1001/jama.2013.278040. https://jamanetwork.com/journals/jama/fullarticle/1745676
Manson JE, Crandall CJ, Rossouw JE, et al. The Women’s Health Initiative Randomized Trials and Clinical Practice: A Review. JAMA. 2024;331(20):1748–1760. doi:10.1001/jama.2024.6542. https://jamanetwork.com/journals/jama/fullarticle/2818206
Santoro, N., Epperson, C. N., & Mathews, S. B. (2015). Menopausal Symptoms and Their Management. Endocrinology and Metabolism Clinics of North America, 44(3), 497-515. https://doi.org/10.1016/j.ecl.2015.05.001
North American Menopause Society. (2022). Nonhormonal management of menopause-associated vasomotor symptoms: 2022 position statement of The North American Menopause Society. Menopause, 29(6), 669-699. https://doi.org/10.1097/GME.0000000000002028
Franco, O. H., Chowdhury, R., Troup, J., Voortman, T., Kunutsor, S., Kavousi, M., Oliver-Williams, C., & Muka, T. (2016). Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA, 315(23), 2554-2563. https://doi.org/10.1001/jama.2016.8012
National Institutes of Health. (2021). Calcium Fact Sheet for Health Professionals. https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
Thurston, R. C., & Joffe, H. (2011). Vasomotor Symptoms and Menopause: Findings from the Study of Women’s Health across the Nation. Obstetrics and Gynecology Clinics of North America, 38(3), 489-501. https://doi.org/10.1016/j.ogc.2011.05.006
Daley, A., Stokes-Lampard, H., Thomas, A., & MacArthur, C. (2014). Exercise for vasomotor menopausal symptoms. Cochrane Database of Systematic Reviews, (11). https://doi.org/10.1002/14651858.CD006108.pub4
U.S. Department of Health and Human Services. (2018). Physical Activity Guidelines for Americans, 2nd edition. https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdf
Sood, R., Sood, A., Wolf, S. L., Linquist, B. M., Liu, H., Sloan, J. A., … & Loprinzi, C. L. (2013). Paced breathing compared with usual breathing for hot flashes. Menopause, 20(2), 179-184. https://doi.org/10.1097/GME.0b013e31826934b6
Register, T. C., Cline, J. M., & Shively, C. A. (2002). Health issues in postmenopausal women who drink. Alcohol research & health : the journal of the National Institute on Alcohol Abuse and Alcoholism, 26(4), 299–307.
Schilling, C., Gallicchio, L., Miller, S. R., Langenberg, P., Zacur, H., & Flaws, J. A. (2005). Relation of body mass and sex steroid hormone levels to hot flushes in a sample of mid-life women. Climacteric, 8(2), 96-104. https://pubmed.ncbi.nlm.nih.gov/17364602/
Farzaneh, F., Fatehi, S., Sohrabi, M. R., & Alizadeh, K. (2013). The effect of oral evening primrose oil on menopausal hot flashes: a randomized clinical trial. Archives of gynecology and obstetrics, 288(5), 1075-1079. https://doi.org/10.1007/s00404-013-2852-6
Kamalifard, M., Farshbaf-Khalili, A., Namadian, M., Ranjbar, Y., & Herizchi, S. (2017). Comparison of the effect of lavender and bitter orange on sleep quality in postmenopausal women: a triple-blind, randomized, controlled clinical trial. Women & health, 57(10), 1145-1160. https://pubmed.ncbi.nlm.nih.gov/28749734/
Lee, K. B., Cho, E., & Kang, Y. S. (2014). Changes in 5-hydroxytryptamine and cortisol plasma levels in menopausal women after inhalation of clary sage oil. Phytotherapy Research, 28(11), 1599-1605. https://doi.org/10.1002/ptr.5163
Stubbs, C., Mattingly, L., Crawford, S. A., Wickersham, E. A., Brockhaus, J. L., & McCarthy, L. H. (2017). Do SSRIs and SNRIs reduce the frequency and/or severity of hot flashes in menopausal women. The Journal of the Oklahoma State Medical Association, 110(5), 272-274. https://pubmed.ncbi.nlm.nih.gov/28649145/
Toulis, K. A., Tzellos, T., Kouvelas, D., & Goulis, D. G. (2009). Gabapentin for the treatment of hot flashes in women with natural or tamoxifen-induced menopause: a systematic review and meta-analysis. Clinical therapeutics, 31(2), 221-235. https://doi.org/10.1016/j.clinthera.2009.02.006
Goldberg, R. M., Loprinzi, C. L., O’Fallon, J. R., Veeder, M. H., Miser, A. W., Mailliard, J. A., … & Dose, A. M. (2010). Transdermal clonidine for ameliorating tamoxifen‐induced hot flashes. Journal of Clinical Oncology, 12(1), 155-158. https://doi.org/10.1200/JCO.1994.12.1.155
Stefanopoulou, E., & Grunfeld, E. A. (2017). Mind–body interventions for vasomotor symptoms in healthy menopausal women and breast cancer survivors. A systematic review. Journal of Psychosomatic Obstetrics & Gynecology, 38(3), 210-225. https://pubmed.ncbi.nlm.nih.gov/27832718/