When a woman hits her 40s and sometimes earlier, her sex hormones begin to shift. For some time, she will be in a new state of hormonal imbalance which can show up as symptoms.
Wherever a midlife woman is on changes: very early perimenopause (high estrogen/declining progesterone), perimenopause (gradually declining estrogen/low progesterone), or post-menopause (low estrogen/low progesterone), relief is often needed and sought.
Here’s the reality: 85% of midlife women report symptoms such as hot flashes, mood swings, and sleep problems. Because most women choose to steer away from hormone therapy – nonhormonal, natural remedies are more popular than ever.
In fact, 50 percent of women have tried complementary and alternative medicine for symptoms relating to perimenopause and menopause with 60% finding them effective.
After digging deep into hormone therapy, I wanted to check the evidence on nonhormonal options. There are prescription alternatives to hormone therapies, but I won’t be addressing those here. I’ll leave those for the book
Here are nonhormonal, natural remedies for the symptoms of perimenopause/menopause with the best evidence. Some might surprise you!
A note about symptoms. When hormones estrogen and progesterone start to fluctuate there can be many different types of symptoms beyond common ones like night sweats and hot flashes. There are estrogen receptors all over the body and so it’s not surprising women may have trouble in a variety of areas: migraines, gastrointestinal issues, mood, oral health, heart (palpitations/fast heart rate) and so on. Feel free to share any symptoms you are having in the comments.
Mind-body therapies like hypnosis are not only effective but offer little in the way of risks and side effects. The mind is the control center of the body and focusing on ways to steer it in a healing direction can be helpful.
Hypnosis involves inducing a deeply relaxed state with individual suggestions for imagery. Hypnosis is not about losing control and forgetting what happened, it’s about a deep focus that is thought to enhance the learning of the subconscious mind.
Although there isn’t a large number of studies, the available research shows hypnosis to be effective. In two randomized clinical controlled trials, 5 sessions of hypnotherapy resulted in a nearly 70% decrease in hot flashes.
According to the 2015 position statement from the North American Menopause Society, “Current evidence for clinical hypnosis is limited but suggests it may be a promising strategy for managing hot flashes.”
Where do you find help?
The American Society of Hypnotists recommends finding a hypnotherapist who is credentialed, certified, and trained. You can start with something much easier by checking out Hypnosis Downloads – they have two audios for menopause.
2. Cognitive Behavioral Therapy
Another evidence-based treatment for vasomotor symptoms (VMS) is cognitive-behavioral therapy (CBT). CBT may address education about how the mind works, the physiology of vasomotor symptoms, negative beliefs about VMS, stress as a trigger, breathing techniques, and sleep hygiene.
Research shows CBT can help with mild depression, hot flash intensity, and psychological symptoms. It also is an evidenced-based technique for treating anxiety which can be especially useful during midlife. According to The North American Society for Menopause position statement, “CBT is an effective treatment for bothersome VMS for both breast cancer survivors and menopausal women.”
And you may not need the help of a therapist. The Menos@work study included women 45-60 years of age with 10 more episodes of hot flashes and night sweats a week. One hundred and twenty-four women were randomly selected to CBT self-help treatment that included a booklet or wait-list control.
The 4-chapter booklet included exercises and practice work to be done at home. Topics covered included menopause and vasomotor symptom education, how to manage stress, and CBT strategies for VMS, sleep, and stress.
After 6- and 20-weeks symptoms and frequency of hot flashes were significantly reduced when compared to controls. Women had improvements in well-being, sleep, and were more productive at work.
Finding a therapist who focuses on menopause symptoms may be tricky, but you can try Psychology Today or the online company Better Help. I found one workbook on Amazon that may be worth a try. CBT for hormonal imbalances needs to be more accessible to women!
3. Mindfulness-Based Stress Reduction (MBSR)
MBSR is an 8-week program created by the pioneer of mindfulness, John Kabat Zinn. It consists of intensive mindfulness training aimed at improving anxiety, pain, stress, and depression (there’s work to do at home too). Although studies show it doesn’t help with vasomotor symptoms such as hot flashes, it has been shown to improve quality of life, stress, and sleep.
Because midlife women are more sensitive to the effects of stress due to both life circumstances and fluctuating estrogen levels, MBSR may be especially helpful. Sleep is another key issue with 42% of 40-50-year-old women reporting poor sleep quality.
Yoga also may improve psychological symptoms but according to the North American Menopause Society, it has not been shown to help with vasomotor symptoms.
Phytoestrogens are plant-derived compounds that include soy and red clover (isoflavones, flaxseeds (lignans), and hops (Humulus Lupulus). Isoflavones are believed to act both estrogenically and anti-estrogenically in the body.
There are four types of isoflavones including genistein, daidzein, glycitein, biochanin A, and Formononetin with genistein and daidzein found in high amounts in soybeans and soy products. Although studies are mixed, most point to isoflavones being more effective than placebo.
One key issue is only about 30% of North American women can metabolize daidzein to equol, which has been shown to have high biological activity. Supplements with equol have been produced but more studies are needed to show if it’s useful.
The North American Society for Menopause recommends: “In postmenopausal women with mild to moderately distressing hot flashes, the S-equol derivatives of the isoflavones may be a reasonable option, providing there isn’t a history of soy intolerance or allergy. If a woman does not respond after 12 weeks, other options should be discussed.”
On a side note, including more plant foods which are also good for health, may mitigate symptoms. In one study, vegan women reported less vasomotor symptoms than women who ate meat.
5. Aromatherapy (Lavender)
Also called essential oil therapy, these oils are extracted aromatic essences from plants. Scented oils are thought to reduce stress and anxiety which may be useful during perimenopause and menopause.
According to one review that included three trials, lavender as a capsule or aromatherapy improved depression, sexual function, anxiety, and key physical symptoms in both menopausal and elderly women.
In another study, smelling lavender aroma for 20 minutes twice per day for 12 weeks, resulting in fewer hot flashes compared to the control group.
Although not considered a stand-alone treatment, lavender can be a safe option for lessening symptoms and improving quality of life.
Acupuncture originates from traditional Chinese medicine. It involves the insertion of small needles to the skin at key points in the body. While research shows it can be helpful for VMS compared to placebo, studies that compare it to sham acupuncture are less impressive.
Some experts say the research is limited because there is no standard acupuncture placebo. This is why the North American Society for Menopause doesn’t recommend it at this time. Others suspect any type of acupuncture might induce a response from the body that releases beta-endorphins that helps with VMS.
That being said, a recent standardized acupuncture approach showed a reduction in hot flashes, emotional symptoms, sleep problems, and skin and hair symptoms just 3 weeks into the study.
Electroacupuncture is a different type of acupuncture used specifically for menopause. It includes the passing of small electrical currents between needles with mixed results in three studies (one showed benefit and two did not).
Although not perfect, there’s evidence acupuncture can help some women with hormonal symptoms.
Little Risk, Potential Benefit
What I like about these remedies is that they offer little risk and often can improve the quality of life in midlife women. They also have evidence that they do work to minimize symptoms in some women.
I have also research herbal remedies and have found a handful with some evidence. I’m giving subscribers a comprehensive review of the evidence for these herbal remedies plus others (29 in total). You might be surprised at what doesn’t work and what does.
Help me make this book the best it can be….the unique health needs of midlife women has been neglected for far too long.