Hormone Replacement Therapy (HRT) Alternatives

Hormone replacement therapy (HRT) is commonly used to treat menopausal symptoms such as night sweats, hot flushes, insomnia, and vaginal dryness. The risks of HRT are high, however, and research has  shown that this therapeutic approach may increase the risk of breast and ovarian cancer.

Natural HRT Alternatives

There are several natural treatment alternatives to HRT which can help control menopausal symptoms effectively. Although the below alternatives shouldn’t be a replacement for conventional medical intervention, they can complement current menopause treatments.

Lifestyle Changes

Regular exercise helps deal with hot flushes and enhances sleep; it also helps improve bone density and combat stress, anxiety, and depression. Walking, dancing, aerobics, and running are ideal.

Wearing loose clothing and staying cool could help relieve night sweats and improve sleep quality. Also, try yoga or other relaxing activities to reduce stress. Smoking cessation is another important factor as smoking can be a cause of hot flushes.

Cropped close up of mature female in yoga Lotus pose indoors. Image Copyright: Elena Ray / Shutterstock
Image Copyright: Elena Ray / Shutterstock


Avoid spicy food, alcohol, and caffeine as they can trigger hot flushes. Additionally, a healthy diet containing calcium and vitamin D-rich foods is essential to fight osteoporosis, a common symptom of menopause.

Foods high in calcium and vitamin D include milk, cheese, yoghurt, and sardines. Other dietary components that may assist in alleviating menopausal symptoms include:

  • B complex vitamins: B vitamins have been shown to be effective in relieving stress, anxiety, panic attacks, and depression by supporting the adrenal glands during times of stress. Supplements containing B1, B6, B12, and folic acid can be helpful if a diet lacks B vitamins. Foods rich in B vitamins include:
    • Meat
    • Egg
    • Fish
    • Greens
    • Dairy
  • Omega 3 fatty acids: Omega 3 fats promote hormone balance and provide lubrication, hence why they are often used to treat vaginal dryness. Good sources of omega 3 fatty acids are oily fish, nuts, greens, and seeds.
  • Vitamin E: Taking about 400 IU of Vitamin E per day has been found to be beneficial in managing hot flushes and vaginal dryness in menopausal women. Food sources of Vitamin E include:
    • Seed oils
    • Avocados
    • Leafy greens
    • Nuts
    • Wheat germ
    • Whole grains
  • Tibolone: This synthetic hormone contains a combination of estrogen and progestogen. It is used to relieve post-menopausal symptoms in women with a womb. It is not effective in relieving perimenopausal symptoms.
  • Phytoestrogenic foods: Phytoestrogen-rich foods help control symptoms of menopause as they balance the function of estrogen receptors in the cell membrane. Such foods include:
    • Lentils
    • Soya foods such as tofu and miso
    • Linseeds
    • Garlic
    • Mung beans
    • Fennel
    • Celery
    • Parsley


Antidepressant medications may help ease depression-like symptoms experienced during menopause. Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine, fluoxetine, and citalopram can help some patients, and serotonin and noradrenaline reuptake inhibitors (SNRIs) such as venlafaxine are said to be effective in controlling menopausal symptoms.

The benefits of antidepressants are typically short acting and aren’t considered a long-term solution for real psychological issues. Also, both SSRIs and SNRIs can cause side effects such as dizziness, nausea, anxiety, and sleeplessness.


A medicine used to treat epileptic pain and seizures, Gabapentin has been shown to ease menopausal symptoms, though it is not licensed for use in menopause. Side effects include fatigue and dizziness.

Lubricants and Moisturizers

Available in pharmacies, lubricants help reduce vaginal dryness. Estrogen creams work in a way similar to HRT to ease vaginal symptoms of menopause and are less risky than HRT tablets.


Originally developed to control blood pressure, clonidine is shown to be effective in reducing hot flushes and night sweats. Side effects include drowsiness, dry mouth, depression, and fluid retention.

Alternative Remedies

Aromatherapy and reflexology have been found to be beneficial in some women for controlling menopausal symptoms. Cognitive behavioral therapy has been shown to improve mood swings and anxiety in women going through menopause.

Herbal products such as black cohosh, red clover, soy, dong quai, angelica, and evening primrose oil are said to be effective in treating menopausal symptoms, though the quality of these unregulated products available in health shops is a matter of concern. These products can also interfere with other treatments and cause a myriad of side effects.


Further Reading

Last Updated: Jan 2, 2023

Susha Cheriyedath

Written by

Susha Cheriyedath

Susha is a scientific communication professional holding a Master's degree in Biochemistry, with expertise in Microbiology, Physiology, Biotechnology, and Nutrition. After a two-year tenure as a lecturer from 2000 to 2002, where she mentored undergraduates studying Biochemistry, she transitioned into editorial roles within scientific publishing. She has accumulated nearly two decades of experience in medical communication, assuming diverse roles in research, writing, editing, and editorial management.


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