What natural menopause treatments actually work?
For hot flashes, the Menopause Society recommends cognitive behavioral therapy and clinical hypnosis, and weight loss for women carrying extra weight. For the body changes of menopause, strength training, protein at every meal, and calcium and vitamin D from food all have strong support. Supplements, herbal remedies, soy and paced breathing are not recommended for hot flashes. Hormone therapy remains the most effective treatment, so natural options work best alongside a conversation with your clinician.
Key takeaways
- Cognitive behavioral therapy and clinical hypnosis have the strongest evidence among non-drug treatments for hot flashes.
- Weight loss is recommended for hot flashes in women carrying extra weight. Keep protein high to protect muscle while you lose.
- Strength training protects muscle and bone, and NICE tells clinicians to explain its importance during menopause.
- Protein at every meal, and calcium and vitamin D from food, support the muscle and bone that menopause puts at risk.
- Smokers reached menopause about 1.8 years earlier in a large study, so stopping is worth it at any age.
- Supplements, herbal remedies including black cohosh, soy and paced breathing are not recommended for hot flashes.
- Hormone therapy is still the most effective treatment. Natural options are a complement, not a reason to avoid your clinician.
"Natural" menopause treatments range from options with strong trial evidence to products that have been tested and failed. The honest version of the list separates two jobs: easing symptoms such as hot flashes, and protecting the muscle and bone that menopause quietly puts at risk. Here are seven that work, and a list of what to skip.
- For hot flashes: CBT, clinical hypnosis, and weight loss if you carry extra weight.
- For muscle and bone: strength training, protein at every meal, calcium and vitamin D from food, and not smoking.
For hot flashes and night sweats
The Menopause Society's 2023 review graded every non-hormone option for hot flashes. These three natural, non-drug options were recommended.1
1. Cognitive behavioral therapy (CBT)
CBT for menopause is a short course of structured talking therapy. It received the Menopause Society's highest level of evidence.1 It is available in person, in groups and online.
If sleep is the main problem, menopause insomnia covers CBT for insomnia, a separate treatment with strong support.
2. Clinical hypnosis
Hypnosis delivered by a trained clinician also received the highest level of evidence for reducing hot flashes.1
3. Weight loss, if you carry extra weight
Weight loss is recommended for hot flashes in women carrying extra weight.1 How you lose it matters in midlife, because muscle is already declining. Keep protein high while calories come down: in a meta-analysis of 24 trials, higher protein diets with the same calories kept about 0.4 kg more lean mass and led to slightly more fat loss.4 The menopause diet 5-day plan shows what that looks like in practice.
For muscle, bone and the years after
These four do not reduce hot flashes, but they protect the parts of your health that menopause affects without any symptoms.
4. Strength training
NICE tells clinicians to explain to everyone going through menopause the importance of keeping muscle mass and strength through physical activity.2 Strength training does both muscle and bone: in the LIFTMOR trial, women around 65 with low bone density improved spine and hip bone density with twice weekly supervised lifting.5 Strength training for women over 50 has a simple plan.
5. Protein at every meal
Muscle needs material as well as training. The Dietary Guidelines for Americans 2025 to 2030 set a goal of 1.2 to 1.6 g of protein per kilogram of body weight a day and tell adults to prioritize protein at every meal.6 Most women fall short at breakfast.
Protein Buddy works out a daily target from a short quiz on your weight, age, activity and goal, and Home shows how many grams are left today as you log. Typing meals in by hand is free with no limit.
6. Calcium and vitamin D from food
After 50, women need 1,200 mg of calcium and 600 IU of vitamin D a day, and more is not better.7 Yogurt, milk, calcium-set tofu and canned fish with bones cover much of it and carry protein too. The osteoporosis diet lists the best foods.
7. Stop smoking
Smoking brings menopause earlier: in the Massachusetts Women's Health Study, current smokers reached menopause about 1.8 years earlier than non-smokers.8 Your doctor can offer support to quit.
What does not work for hot flashes
| Verdict | Source | |
|---|---|---|
| Black cohosh | No better than placebo | Cochrane review, 16 trials |
| Other supplements and herbal remedies | Not recommended | Menopause Society 2023 |
| Soy foods, soy extracts, equol | Not recommended for hot flashes | Menopause Society 2023 |
| Paced breathing | Not recommended | Menopause Society 2023 |
| Yoga, exercise, cooling, avoiding triggers | Not recommended as a hot flash treatment | Menopause Society 2023 |
The Cochrane review pooled 16 trials with 2,027 women and found no difference between black cohosh and placebo in how often hot flashes happened.3 The Menopause Society did not recommend the other items for hot flashes.1
Two of those deserve a second look. Soy is still a good food: calcium-set tofu is one of the best sources of both protein and calcium. And exercise is still one of the most valuable habits of midlife, for muscle, bone, heart and mood. Neither is a hot flash treatment, and that is all the review says. Perimenopause supplements covers the supplement shelf in more detail.
If you are comparing options, hormone balancing supplements covers the blends on the shelf and prescription medicine for menopause the treatments your clinician can offer.
Natural is not the only option
The Menopause Society says hormone therapy remains the most effective treatment for hot flashes and should be considered for women within 10 years of their final period, and it also recommends several prescription non-hormone medicines.1 Whether any of those suit you depends on your age, health and history, so it is worth a conversation with your clinician, especially if symptoms are affecting your sleep, work or mood. Hot flashes sets out all the options side by side.
More questions about Women over 40
What is the most effective natural treatment for hot flashes?
Cognitive behavioral therapy and clinical hypnosis both have the highest level of evidence in the Menopause Society's 2023 review of non-hormone treatments. For women with extra weight, weight loss is also recommended. None of them is as effective as hormone therapy.
Do herbal remedies work for menopause?
Not for hot flashes, according to the evidence. The Menopause Society does not recommend supplements or herbal remedies, and a Cochrane review of 16 trials found black cohosh no better than placebo. Some herbs can also interact with medicines, so tell your doctor about anything you take.
Does exercise help menopause symptoms?
Exercise does not reliably reduce hot flashes, according to the Menopause Society's review. But strength training is one of the most important things you can do in menopause for muscle and bone, and NICE tells clinicians to explain the importance of keeping muscle mass and strength through physical activity.
Is soy good for menopause?
Soy foods are a good source of protein, and calcium-set tofu is rich in calcium, so they are useful foods in menopause. But the Menopause Society does not recommend soy foods, soy extracts or equol as a treatment for hot flashes.
Can I manage menopause without hormones?
Many women do. Non-hormone options include CBT, hypnosis, weight loss and several prescription medicines for hot flashes, and local treatments for vaginal dryness. Whether that is enough depends on how severe your symptoms are, which is worth discussing with your clinician.
References
- The 2023 nonhormone therapy position statement of The North American Menopause Society
- Menopause: identification and management (NG23)
- Black cohosh (Cimicifuga spp.) for menopausal symptoms
- Effects of energy-restricted high-protein, low-fat compared with standard-protein, low-fat diets: a meta-analysis of randomized controlled trials
- High-Intensity Resistance and Impact Training Improves Bone Mineral Density and Physical Function in Postmenopausal Women With Osteopenia and Osteoporosis: The LIFTMOR Randomized Controlled Trial
- Dietary Guidelines for Americans, 2025-2030
- Dietary Reference Intakes for Calcium and Vitamin D
- The normal menopause transition
