This article is part of WHA’s perimenopause and menopause series.

For many, Menopause Hormone Therapy (MHT)—previously known as Hormone Replacement Therapy—provides vital relief from menopause symptoms, but it’s not the only way to navigate menopause with confidence and comfort.

Each person’s experience with menopause is unique, and so are the options available to manage its symptoms. If MHT isn’t the right fit—whether due to health considerations or personal preference—you still have a range of effective alternatives.

How providers assess menopause treatment options

When considering whether Menopause Hormone Therapy is the best treatment for you, your provider will review your health history, menopause symptoms and cardiac risk score in detail. This comprehensive assessment helps determine whether MHT is appropriate or if non-hormonal treatments might be safer or more effective for you.

Key factors like your personal and family history of heart disease, stroke or blood clots guide these decisions, as certain conditions may increase risks associated with hormone therapy. While MHT is a safe and effective choice for many, your provider’s priority is tailoring a solution that meets your unique health needs.

Why Menopause Hormone Therapy might not be right for you

Common reasons to consider alternatives to MHT:

  • Medical conditions: A history of breast cancer, heart attack, stroke, blood clots, or liver disease.
  • Personal preference: Concerns about using hormones or preference for non-hormonal options.

Discussing non-hormonal menopause symptom relief options

Open communication with your provider is essential when evaluating non-hormonal treatments for menopause. Start by sharing any health concerns, preferences and symptoms you’re experiencing. Your provider can then guide you through options that align with your health goals and comfort level.

You’ll create a personalized treatment plan together, and regular follow-up appointments allow for adjustments as your needs change. Rest assured, even without MHT, a range of effective treatments can relieve symptoms and address key health aspects like bone density and vaginal health.

Non-hormonal medications for menopause symptoms

For those who can’t or choose not to use menopause hormone therapy, there are effective medication alternatives that target specific menopause symptoms. For vasomotor symptoms, such as hot flashes, night sweats and sleep disruptions caused by these things, medications such as the ones below work by targeting the body’s temperature regulation and stress response systems, reducing the frequency and intensity of hot flashes and night sweats while often aiding in better sleep:

  • SSRIs (selective serotonin reuptake inhibitors)
  • Gabapentin
  • Clonidine
  • Effexor (SNRI)

One newer option you and your provider may consider is Veozah, a non-hormonal medication designed specifically to prevent hot flashes and night sweats. Veozah works in the brain, and while it’s generally safe, patients using it will need routine liver function checks to ensure continued health.

How diet and lifestyle changes can help manage menopause symptoms naturally

A well-rounded approach to managing menopause symptoms often starts with the basics: diet, exercise and sleep—regardless of any other method for symptom relief. These foundational elements play a significant role in supporting long-term health and can help ease many common menopause symptoms.

While hormone therapy remains a safe and effective option, lifestyle adjustments provide a natural, accessible foundation for feeling better throughout this transition, and research underscores the impact of a nutrient-rich diet and regular physical activity.

For instance, eating foods high in vitamin D and calcium promotes bone health and can improve mood stability. Weight-bearing exercises like walking or light strength training help maintain bone density and reduce osteoporosis risk, while cardiovascular exercise supports heart health. Adding practices like yoga or meditation can enhance mental well-being, offering stress relief while improving sleep.

By focusing on these key areas, some may find they can manage menopause symptoms effectively while also enhancing their overall wellness.

Is it worth taking supplements for menopause?

Supplements often enter the conversation around menopause symptoms, especially now with so many influencers selling products. But to put it simply: don’t waste your money!

While black cohosh, one of the most commonly recommended supplements, has shown minimal evidence in treating hot flashes, other supplements have even less scientific backing. Supplement companies make bold claims, but the reality is it’s a multi-billion-dollar industry and few non-prescription remedies provide reliable relief for menopause symptoms, if any at all.

Beyond non-effectiveness, unregulated supplements carry potential risks. Unlike FDA-approved medications, supplements don’t undergo rigorous testing, so quality and safety vary widely. For example, turmeric, though popular, can cause elevated liver function levels when taken in high doses.

For most people, focusing on a balanced diet is a healthier, more effective and less costly approach. If social ads and influencers have piqued your curiosity, please chat with your provider before buying anything. They can provide the full context on these supplements, helping you make a more informed decision.

Non-hormonal and alternative therapies for menopause symptoms

There are non-hormonal and alternative therapies for menopause symptom management but with varying levels of evidence.

Therapies such as acupuncture, yoga and hypnosis do not significantly alleviate vasomotor symptoms like hot flashes and night sweats, but they can still promote overall wellness. On the other hand, cognitive behavioral therapy has shown substantial research support for effectively managing hot flashes and insomnia.

If you find that alternative therapies enhance your personal wellness, they are certainly worth considering.

Effective menopause care is collaborative

It’s important to recognize that effective alternatives to menopause hormone therapy are available, enabling you to select the path to care that aligns with your unique needs and preferences. Whether opting out of hormone therapy is a personal choice or due to medical reasons, you and your provider should work together to find the best solution for you.

If hormone therapy isn’t suitable for any reason, rest assured we will identify an approach that allows you to lead a fulfilling, healthy life. I am personally in this stage of life, too, so I get it. It’s not an easy time, but you WILL be okay. Schedule an appointment today.