Mood swings, hot flashes, and many of the other symptoms of perimenopause and menopause are treatable. When you consult with your physician, bring a list of your experiences so far — and what you have done to cope.
Please note that herbs and supplements have not been proven to reduce menopause symptoms in research studies. Also, they are not regulated by the U.S. Food and Drug Administration (FDA) and may interact with other medications you are taking. With that in mind, here are some treatments and coping strategies to help ease your symptoms.
What Are the Top Symptoms of Perimenopause and Menopause?
Dr. Kelly Casperson, MD, outlines the primary symptoms associated with perimenopause and menopause.
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Medical Treatments for Symptoms of Menopause and Perimenopause
1. Hormone Therapy
Most menopause symptoms (hot flashes, insomnia, night sweats, osteoporosis, mood swings, decreased libido) are caused by declining levels of estrogen, a hormone primarily produced by the ovaries. Hormone therapy, or hormone replacement therapy, is exactly what it sounds like — increasing estrogen levels via oral medication, skin patches, or vaginal creams, rings, or gels. It can contain estrogen alone or estrogen and progestin together. There has been controversy around hormone therapy in the past, concerning its connection to a heightened risk of breast cancer and cardiovascular disease, but more recent research has shown these risks to be minimal for most women. There’s no one-size-fits-all recommendation, so it’s important to discuss your medical history with your doctor, to weigh the potential risks and benefits of various menopause treatments.
2. Antidepressants
Some classes of antidepressants — notably, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors — can aid in mood stabilization and also help reduce hot flashes. Antidepressants are considered nonhormonal medical treatments for symptoms related to perimenopause and menopause. Currently, paroxetine (Brisdelle) is the only SSRI approved by the FDA for the treatment of hot flashes.
3. Gabapentin
Gabapentin is a drug designed to mimic the effects of the neurotransmitter gamma-aminobutyric acid (GABA). GABA sends chemical messages through the brain and the nervous system and is involved in regulating communication between brain cells. GABA levels have been shown to be lower in postmenopausal women, leading to symptoms of depression.
Gabapentin was originally a seizure medication, but it is also effectively used off-label in reducing hot flashes and improving sleep. Since it does not contain reproductive hormones, it can be used by women with breast cancer. It can carry significant side effects, including blurred vision, sleepiness, nausea, dizziness, and tremors.
4. Bioidentical Hormones
Bioidenticals are compounds that closely resemble the chemical and molecular structure of human hormones. Many false and misleading statements have been made out about these compounds, such as that they are safer and more effective than hormone therapy, but these claims have not been verified. That said, the FDA has approved a bioidentical combination drug called Bijuva (estradiol and progesterone) for hot flashes.
A note of caution: One way that bioidentical hormones are prescribed and made available is through compounding pharmacies. Compounded drugs are not FDA regulated and should be approached with caution. The concern is mainly about bioidenticals that are custom compounded by pharmacists following a doctor’s script. These have no FDA oversight, and there is no evidence that they are superior to regular hormone therapy or bioidenticals that have FDA approval.
5. Neurokinin Receptor Antagonists
Fezolinetant (Veozah) is a newer, oral medication that is FDA-approved for treating moderate to severe hot flashes. It works by managing the cause of hot flashes in the brain’s signaling. If you’re taking this medication, watch out for symptoms such as new-onset fatigue, jaundice, nausea, and vomiting. If you experience any of these, stop taking fezolinetant, as it can cause rare but serious liver injuries.
Elinzanetant (Lynkuet), another neurokinin receptor antagonist, was FDA approved in October 2025 to treat moderate to severe hot flashes. Like fezolinetant, it works by managing the brain’s chemical signaling to prevent hot flashes; however, no serious side effects were noted in clinical trials.
6. Oxybutynin (Ditropan XL, Oxytrol)
This drug is commonly used for overactive bladder, but studies have found that oxybutynin reduces hot flashes by 70 to 86 percent. Note that it is used off-label for menopause treatment. Oxybutynin is not considered a drug of choice for people over the age of 65, due to the possibility of cognitive impairment. So if you’re looking for postmenopausal relief, your doctor may or may not recommend this drug based on your age, health history, risk factors, and other medications.
Related Treatments Midlife Women May Need: Osteoporosis Medications
To prevent further bone loss, experts recommend that women get sufficient doses of calcium and vitamin D. Your doctor can help determine whether you need calcium or vitamin D supplements. If there is evidence of osteoporosis, or if you are at a higher risk of osteoporosis based on family history, medical history, or use of certain medications, your doctor may prescribe one of these osteoporosis medications:
risedronate (Actonel, Atelvia), ibandronate (Boniva), alendronate (Binosto, Fosamax): Prevents bone deterioration via an oral pill
zoledronate (Reclast): Given once a year by IV, for people who have trouble taking the above medicines orally
denosumab (Prolia): Antibody injection given twice a year
raloxifene (Evista): Mimics estrogen
teriparatide (Forteo), abaloparatide (Tymlos), and romosozumab (Evenity): Injectables that contain a bone-building agent
Complementary and Alternative Remedies for Perimenopausal and Menopausal Symptoms
Ask your doctor about incorporating these modalities into your overall regimen.
1. Acupuncture
Older studies show that acupuncture may help relieve vasomotor symptoms (VMS) such as hot flashes and night sweats. Research found that “the majority of women may experience a significant reduction in menopause-related VMS frequency after eight weeks of acupuncture treatment, and that there is a subgroup of women who are likely to experience an especially rapid and strong clinical response to acupuncture.” Newer research focuses more on acupuncture for VMS relief during cancer treatment, as opposed to menopause, but data continues to show that it provides relief from hot flashes.
2. Hypnotherapy
While there has been less research done on this topic, a clinical trial of 250 postmenopausal women found that self-administered hypnosis via audio recordings reduced the severity and frequency of hot flashes by more than 50 percent.
3. Yoga
It looks like this ancient practice can help with a variety of menopause symptoms: It lowers the risk of cardiovascular disease, hot flashes, and night sweats; improves sleep, mood, and cognitive function; and can help improve bone mineral density.
4. Mindful Meditation
Mindfulness, the practice of staying in the moment, focusing on the “now,” and avoiding judgment, has been shown to reduce the degree of distress that women feel from hot flashes, night sweats, and stress, according to some preliminary research. Also, deep, controlled breathing when you feel a hot flash coming on signals your body to relax.
5. Cognitive Behavioral Therapy
Cognitive behavioral therapy, either as a group or self-guided, also appears to improve hot flashes, and it can also help with mood and sleep changes that may accompany perimenopause and menopause.
6. Stellate Ganglion Block
This injection of an anesthetic into the stellate ganglion nerve in the back of the neck is often used for pain management, and it may also decrease hot flashes. More research is needed for more definitive evidence, but it shows promise as an alternative therapy.
Strategies for Coping With Specific and General Menopausal Symptoms
1. To Cope With Hot Flashes, Dress in Layers
You’re hot, then you’re cold, and then you’re hot again. Instead of changing outfits several times a day, pile on layers (camisole, T-shirt, cardigan) that can easily be removed and put back on. Avoid fabrics that don’t breathe, such as polyester and jersey.
2. To Cope With Vaginal Dryness, Use Vaginal Lubricants and Moisturizers
If your vagina or vulva is getting dry and irritated, stop using soap to clean there; clean water works just as well. If sexual penetration is painful because of dryness, try an over-the-counter lubricant or moisturizer. Use lubricants right before sexual activity; avoid ones with additives, which can cause irritation. Keep in mind, however, that moisturizers need to be applied regularly in order to see improvement, not just before intercourse. If this is insufficient, you may benefit from vaginal estrogen, which should be discussed with your doctor.
3. To Cope With Menopausal Health Risks, Eat a Bone-Healthy Diet
Add calcium and vitamin D to your plate: Low-fat dairy, canned salmon, sardines and shrimp, eggs, fortified juice, and leafy green vegetables help protect against osteoporosis. Check with your physician before taking vitamin C supplements (or any supplement), because they can interact with some medications.
4. To Cope With Various Symptoms, Avoid Caffeine, Alcohol, and Spicy Foods
These ingredients and foods can trigger mood swings, night sweats, and hot flashes. Alcohol can increase your risk of cardiovascular disease and osteoporosis.
5. Quit Smoking
Cigarettes can not only cause an earlier onset of menopause but also increase the intensity of symptoms and the risk of developing cardiovascular disease and osteoporosis.
6. Strengthen Your Pelvic Floor
Pelvic floor muscle exercises specifically designed for you by a physical therapist with special training in pelvic floor therapy can improve your strength and tone, relax tight muscles, and overcome embarrassing “leaking” (incontinence), pelvic organ prolapse, and sexual dysfunction.
7. Get Regular Exercise
All different kinds of exercise are important. The Centers for Disease Control and Prevention recommends 150 minutes of moderate physical activity each week or 75 minutes of vigorous activity each week. A combination of the exercises below may help with menopause symptoms, in addition to boosting your overall health:
Aerobics to protect your heart and work off unwanted weight
Weight-bearing exercises to strengthen bones
Strength-training to prevent loss of muscle mass
Stretching to loosen stiff muscles and tendons
As a bonus: Regular exercise is known to improve your mood and help minimize depression. If you don’t know where to start, find a trainer who can create an appropriate workout plan for you.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
Iyer TK et al. Review: Nonhormone Therapies for Menopausal Hot Flashes. Cleveland Clinic. July 9, 2024.
Hormone Therapy for Menopause Symptoms. Cleveland Clinic. March 12, 2024.
Gilfarb RA et al. GABA System Modifications During Periods of Hormonal Flux Across the Female Lifespan. Frontiers in Behavioral Neuroscience. June 16, 2022.
DePolo J. Hot Flash Medications for People With Breast Cancer. BreastCancer.org. November 14, 2025.
FDA Adds Warning About Rare Occurance of Serious Liver Injury With Use of Veozah (Fexolinetant) for Hot Flashes Due to Menopause. U.S. Food and Drug Administration. December 20, 2024.
McNulty R. FDA Approves Elinzanetant, a Hormone-Free Option for Hot Flashes in Menopause. American Journal of Managed Care. October 24, 2025.
Osteoporosis Treatment: Medications Can Help. Mayo Clinic. August 28, 2024.
Avis NE et al. Trajectories of Response to Acupuncture for Menopausal Vasomotor Symptoms: The Acupuncture in Menopause (AIM) Study. Menopause. February 1, 2018.
Can Acupuncture Lessen Hot Flashes and Other Side Effects of Anti-Hormonal Breast Cancer Therapy. Wiley. June 24, 2024.
Elkins G et al. Self-Administered Hypnosis Versus Sham Hypnosis for Hot Flashes: A Randomized Clinical Trial. JAMA Network Open. November 11, 2025.
Xu H et al. Effects of Mind-Body Exercise on Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-Analysis. Menopause. May 1, 2024.
Kara Smythe, MD, has been working in sexual and reproductive health for over 10 years. Dr. Smythe is a board-certified fellow of the American College of Obstetricians and Gynecologists, and her interests include improving maternal health, ensuring access to contraception, and promoting sexual health.
She graduated magna cum laude from Florida International University with a bachelor's degree in biology and earned her medical degree from St. George’s University in Grenada. She completed her residency in obstetrics and gynecology at the SUNY Downstate Medical Center in Brooklyn, New York. She worked in Maine for six years, where she had the privilege of caring for an underserved population.
Smythe is also passionate about the ways that public health policies shape individual health outcomes. She has a master’s degree in population health from University College London and recently completed a social science research methods master's degree at Cardiff University. She is currently working on her PhD in medical sociology. Her research examines people's experiences of accessing, using, and discontinuing long-acting reversible contraception.
When she’s not working, Smythe enjoys dancing, photography, and spending time with her family and her cat, Finnegan.
Beth Levine is an award-winning health writer whose work has appeared in The Washington Post, The New York Times, O: The Oprah Magazine, Woman's Day, Good Housekeeping, Reader's Digest, AARP Bulletin, AARP The Magazine, Considerable.com, and NextTribe.com. She has also written custom content for the Yale New Haven Hospital and the March of Dimes.
Levine's work has won awards from the American Academy of Orthopaedic Surgeons, the Connecticut Press Club, and the Public Relations Society of America. She is the author of Playgroups: From 18 Months to Kindergarten a Complete Guide for Parents and Divorce: Young People Caught in the Middle. She is also a humor writer and in addition to her editorial work, she coaches high school students on their college application essays.
