Treatment options
for perimenopausal symptoms

Some women choose to go through perimenopause without getting any treatment, while others prefer some form of treatment to help manage their symptoms. There are a range of treatment options for perimenopausal symptom relief, including prescribed hormonal and non-hormonal treatments, complementary and alternative therapies, and lifestyle recommendations that can help make life easier. 

Hormonal therapy

Hormone Replacement Therapy (HRT): HRT, also known as hormone therapy, is a medication that replaces the oestrogen and progesterone you lose during perimenopause. It helps stabilise your hormone levels, thereby reducing symptoms including hot flashes and night sweats, problems sleeping, mood swings, loss of libido, and vaginal dryness. It may also protect your heart and bones. It comes in a range of doses and is available as tablets, skin patches, vaginal creams, or gels. If you are thinking about starting HRT, you should discuss the potential risks and benefits with your doctor first, as it is not suitable for everyone.

Birth control: For some women, remaining on the birth control pill offsets perimenopausal symptoms. The birth control pill reduces hot flashes, and alleviates heavy or painful periods in perimenopause.

Non-hormonal therapy

SSRIs: Anti-depressant medications can reduce hot flashes and mood swings. Gabapentin: Originally used to treat seizures, gabapentin can also help manage hot flashes.
Veoza: A newly approved medication called fezolinetant (Veoza) blocks temperature regulation pathways in the brain and relieves hot flashes.

Over-the-counter products

Magnesium: Magnesium supplements can help some women with lack of sleep or insomnia, according to research.
Creams and lubricants: These are used to treat symptoms like vaginal dryness and discomfort.
Calcium and vitamin D: Be sure you are getting enough calcium and vitamin D as the risk of osteoporosis rises during perimenopause. Eat foods rich in calcium such as dairy products, leafy green vegetables, almonds, and dried beans. Ask your doctor if taking a supplement with calcium and vitamin D could benefit you.

Complementary and alternative treatments

Herbal supplements: Some women get some relief from their symptoms by taking herbal supplements such as black cohosh, evening primrose oil, or red clover. As with any supplements, you should always check with your doctor first to make sure they’re safe for you.

Cognitive behavioural therapy (CBT): CBT is a type of counselling that focuses on changing certain thoughts and behaviour patterns. It can help you to feel less bothered by hot flashes.

Acupuncture: Some studies suggest that acupuncture can reduce the severity of hot flashes and improve overall wellbeing during perimenopause.

Yoga: According to several studies, yoga can be very effective for reducing menopausal symptoms. Women have also reported that yoga stretching and relaxation techniques lift their mood and improves their quality of life during perimenopause.

Hypnotherapy: Hypnotherapy can help you manage and reduce the symptoms of perimenopause. It has been shown to reduce the frequency and intensity of hot flushes in addition to helping with mild depression and anxiety. According to research, focusing on cooling imagery during hypnosis gives you greater control over hot flashes and can even help prevent them altogether. 

Lifestyle recommendations

Eat a healthy diet: Eat a balanced diet rich in fruits, vegetables, whole grains, and lean proteins to promote overall health and make the transition to perimenopause easier.

Get regular exercise: Engage in regular exercise to help manage weight, strengthen bones, and improve sleep and mood. Try to fit in 30 to 60 minutes every day, five days a week, of both aerobic exercise such as running and swimming, and strength training exercise. Low-intensity exercise, such as yoga and Pilates, can strengthen the pelvic floor and decrease urinary incontinence. 

Develop a good sleep routine: Practice good sleep hygiene to minimise sleep disruptions due to hot flashes at night. Try cutting out alcohol and caffeine to promote better sleep. Create a relaxing bedtime. Whether it’s a warm bath, reading a book, or meditating, relaxation techniques about an hour before bed can put you in the right mindset. Good sleep is also more likely if your bedroom feels restful and cool.

Manage hot flashes: Avoid foods and activities that trigger hot flashes such as alcohol, caffeine, smoking, spicy food, hot weather, and tight clothes. Use cooling sheets, lighter blankets, wear pyjamas made out of cotton, and keep a glass of water or fan nearby.

Engage in stress management techniques: Engage in stress-reducing techniques such as meditation, mindfulness, deep breathing, and yoga.

Engage in new activities that bring joy: Join a club, volunteer, learn a new skill, or take up a new hobby.