In the time leading up to menopause, a person may have symptoms such as hot flashes, difficulty sleeping, and pain during sex. They can try natural methods, such as exercising and making changes to their diet, to help manage these symptoms.

According to the National Institute on Aging (NIA), menopause occurs 12 months after a person has their last period.

Perimenopause is the time leading up to menopause. It is during this time that people first start to experience symptoms. These symptoms occur as a result of fluctuating levels of progesterone and estrogen.

Although hormone replacement therapy (HRT) can help treat these symptoms, a person can also try natural remedies.

This article will look at some natural remedies that may help people manage the symptoms of perimenopause.

The NIA notes that the symptoms of perimenopause include:

  • period changes
  • hot flashes
  • vaginal dryness
  • urinary incontinence
  • bladder infections
  • difficulty sleeping
  • night sweats
  • less interest in sex
  • depression
  • weight gain
  • headaches
  • heart palpitations

Additionally, the bones can become less dense, which means a person has a higher chance of experiencing fractures.

Individuals may be able to manage and alleviate some of these symptoms using natural methods, including dietary changes, certain exercises, and mindfulness techniques.

There needs to be more research on the effects of herbal supplements in treating perimenopause symptoms. Additionally, some herbal supplements may cause adverse side effects.

Learn more about the effectiveness and safety of herbal remedies for menopause.

A person should always talk with a healthcare professional before trying any new supplements.

The Food and Drug Administration (FDA) does not review dietary supplement products to determine their effectiveness or safety.

In addition, the National Institutes of Health (NIH) note that taking too much of some supplements can cause harmful side effects or lead to certain health conditions.

The FDA warns that people should avoid any supplements that make bold claims, such as:

  • “works better than [a prescription drug]”
  • “totally safe”
  • “no side effects”

Black cohosh

Some people use black cohosh to treat certain symptoms of perimenopause, including:

  • hot flashes
  • night sweats
  • vaginal dryness
  • sleep disturbances
  • irritability

However, side effects of black cohosh can include:

Additionally, black cohosh can interact with prescription medication. It is important to contact a healthcare professional before using this supplement.

Learn more about black cohosh.

Red clover

According to the National Center for Complementary and Integrative Health, red clover contains isoflavones and phytoestrogens. These are compounds similar to the hormone estrogen.

However, there does not appear to be any consistent evidence to suggest that it is an effective natural remedy for the symptoms of perimenopause.

Other herbal supplements

Some other herbal supplements that people may consider using to manage the symptoms of perimenopause include:

However, it is important to note that there has not been enough research to confirm the safety of these herbs. Additionally, they may not be effective.

One 2019 article noted that some may cause unwanted side effects or interfere with certain medications.

During perimenopause, a person may experience stress and depression. To relieve these conditions, they can try the following:

  • Hypnosis: A 2017 study found that hypnosis was as effective as venlafaxine in reducing hot flashes. Venlafaxine is a common prescription drug treatment for hot flashes.
  • Cognitive behavioral therapy (CBT): According to a 2019 article, some studies have found that CBT may help reduce mild depression and the frequency of hot flashes.
  • Biofeedback and relaxation training: The same 2019 article noted that relaxation techniques, such as progressive muscle relaxation, may help reduce how often a person experiences hot flashes. They may also help reduce psychological symptoms of perimenopause. However, more research is necessary.

Learn more about relaxation techniques to try here.

Mindfulness-based stress reduction (MBSR) uses a variety of exercises, including yoga and meditation.

One 2019 article found that MBSR is safe and can:

  • reduce stress
  • reduce anxiety
  • improve sleep quality

The NIA states that mindfulness meditation, yoga, and other activities, such as tai chi, may help improve hot flashes.

However, it is important to note that more research is necessary to determine their effects on vasomotor symptoms, including night sweats and hot flashes.

Aromatherapy is another method that can help manage the psychological symptoms of perimenopause.

An older 2012 study involving 90 people found that aromatherapy combined with massage was beneficial in reducing psychological symptoms.

Learn more about aromatherapy.

As well as being able to help a person reach and maintain a moderate weight, exercise may help alleviate vasomotor menopausal symptoms, such as hot flashes and night sweats. Research into this is ongoing.

The researchers behind one 2019 study found that people with moderate-to-high levels of physical activity had less severe symptoms than those who were inactive.

Additionally, a 2014 study found that although 12 weeks of moderate exercise did not alleviate vasomotor symptoms, it may have resulted in an improvement in:

One 2019 article suggested that people get 150 minutes of moderate-intensity physical activity each week. This can include:

  • walking
  • jogging
  • cycling
  • swimming

Resistance training may also help maintain bone and muscle mass.

The 2019 article suggested a combination of aerobics, balance exercises, and resistance training to help manage weight, psychological symptoms, and vasomotor symptoms.

Yoga may also help relieve hot flashes and improve sleep quality.

A 2019 article in the Journal of Mid-Life Health stated that menopause is a significant cause of weight gain. This may be a result of low circulating estrogen levels.

People should try to incorporate foods high in fiber and antioxidants in their diet. They should also limit salt, sugar, and processed foods.

People may also benefit from eating five or six smaller meals each day.

Learn more about managing weight during menopause here.

Consuming foods that contain high amounts of iron may help reduce:

  • hot flashes
  • heart palpitations
  • insomnia
  • irritability

Foods high in iron include:

  • fortified breakfast cereals
  • white beans
  • dark chocolate
  • kidney beans
  • tomatoes
  • cashew nuts
  • green vegetables, including broccoli, spinach, kale, asparagus, and parsley

Learn more about iron-rich foods here.

During perimenopause, a person’s bone density can decrease. Calcium and vitamin D can help maintain bone health in postmenopausal people.

Some dairy foods that contain high levels of calcium include:

  • yogurt
  • cheese, such as cottage cheese, mozzarella, and Cheddar
  • milk

Some nondairy options include:

  • soy milk
  • tofu
  • chia seeds

Learn more about nondairy sources of calcium here.

A person can also find calcium in kale, broccoli, and orange juice.

Vitamin D is available in the following foods:

  • fish, including salmon, trout, and sardines
  • mushrooms
  • milk
  • soy milk
  • Cheddar cheese
  • lentils
  • fortified breakfast cereals

One 2017 article suggested that phytoestrogens may help reduce the chance of developing symptoms during perimenopause.

In addition, a 2015 systematic review stated that phytoestrogens appear to help reduce the frequency of hot flashes.

However, the 2017 article also stated that there is insufficient data and there may be some health risks associated with phytoestrogens.

If a person decides to include foods high in phytoestrogens in their diet, they should do so in moderate amounts and as part of an overall balanced diet.

Learn more about foods high in phytoestrogens here.

A person can apply topical flaxseed oil or vitamin E oil to the vagina to help improve lubrication and vaginal dryness.

There is some evidence to suggest that vitamin E suppositories could help relieve vaginal atrophy.

The Academy of Nutrition and Dietetics notes that drinking water can help reduce hot flashes.

As a person may experience an increase in urinary tract infections during perimenopause, drinking plenty of water may help prevent recurrent infections.

According to some researchers, people should aim to drink at least 2 liters of water per day.

According to the Urology Care Foundation, strengthening the pelvic muscles can help reduce urinary incontinence.

Learn how to perform Kegel exercises here.

People who undergo perimenopause may experience vaginal dryness. This can increase friction and lead to pain or discomfort during sexual activity.

A person may wish to purchase vaginal moisturizers or lubricants to reduce pain and discomfort.

Learn more about the best vaginal moisturizers.

However, a person should carefully read the ingredients to ensure they are not allergic to any of them. Individuals may experience symptoms such as redness, swelling, or itching if they have an allergy or sensitivity to one of the ingredients in a moisturizer.

People who are not sure which product to purchase may wish to consider a water-based moisturizer. These products are less likely to cause an allergic reaction.

According to the NIA, the following things can trigger hot flashes:

  • alcohol
  • caffeine
  • spicy foods

A person may wish to avoid these during perimenopause.

To reduce hot flashes, a person can try:

  • dressing in layers that they can remove when a hot flash occurs
  • carrying a portable fan
  • quitting smoking, if applicable

Learn more about natural remedies for hot flashes here.

A healthcare professional may suggest some other treatment options, including:

Learn more about medical treatment options for perimenopause here.

A person should always contact a doctor before trying any new treatments, particularly if they are taking hormonal or other prescription medications.

This is because certain supplements and herbal treatments may interfere with other medications a person is taking. A healthcare professional will be able to advise on which natural remedies may be suitable.

A person should also contact a doctor if their symptoms are causing them concern.

Below are the answers to some common questions about perimenopause.


Can a person manage the symptoms of perimenopause using natural remedies alone?



It is possible. Many people report relief of their symptoms using some of the alternative, natural therapies out there. In general, however, there are not a lot of solid data on whether these therapies are effective, so it is always a good idea for a person to talk with a doctor if they are interested in this route.

Carolyn Kay, MDAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
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How long does menopause last?

According to the National Health Service in the United Kingdom, most people will have symptoms of menopause for 4 years from their last period.

However, around 1 in 10 people will have symptoms of menopause for up to 12 years.

What are some signs that I am coming to the end of perimenopause?

Perimenopause can cause symptoms such as irregular periods, hot flashes, and vaginal dryness.

However, healthcare professionals define the end of perimenopause and the start of menopause as the period when a person does not menstruate for 12 months.

How do I manage my weight during menopause?

Research from 2014 suggests that the number of calories a person burns during rest declines during and after menopause.

A person should eat a healthy, balanced diet and take part in regular physical activity to manage their weight during menopause.

Learn more about weight management during menopause.

Some people may wish to try supplements that may help them manage their weight. It is important to contact a healthcare professional before purchasing and taking weight management supplements, to ensure they are suitable for a person’s requirements and safe to consume.

Learn more about the best weight management supplements for menopause.

People may experience a variety of symptoms during perimenopause. These can include hot flashes, night sweats, and vaginal dryness.

Some natural remedies for these symptoms include:

  • mindfulness techniques
  • aromatherapy massage
  • physical activity
  • a balanced diet
  • foods high in iron, calcium, and vitamin D

A person should talk with a healthcare professional before trying any herbal remedies. This is because herbal remedies can cause side effects and interact with other medications.