Nearly 34 million American women are between the ages of 40 and 54, according to the US Census Bureau. Most are in some stage of menopause. If you're among them, you may be wondering about the best ways to deal with the symptoms. Fortunately, several natural remedies and medicines can help. They are safe and effective—and some work quickly, particularly if you have mild to moderate symptoms.

Menopause is a normal stage in a woman's life. Unless a woman has another reason such as low body weight or vigorous athletic training, if a woman hasn't had a period for 12 consecutive months, she is considered to have reached menopause. In the US, the average age is 51. During menopause, ovaries produce less of the hormones estrogen, progesterone and testosterone. Meanwhile, there's an increase in the release of two hormones produced by the pituitary gland—follicle stimulating hormone (FSH) and luteinizing hormone (LH). Doctors believe the surge of these latter two hormones triggers menopausal symptoms, including hot flashes (which affect three-quarters of American menopausal women) and vaginal dryness. You also may experience insomnia, depression and mood swings.

In the year or two before menopause, many women go through perimenopause, or premenopause, during which hot flashes and other symptoms usually begin. The menstrual cycle becomes irregular. A period of lingering symptoms after menopause is called postmenopause. The therapies I recommend are effective for women in any stage, from perimenopause to postmenopause- but not one of these therapies includes typical pharmaceuticals. Here's why...


Sixty years ago, doctors started giving women synthetic estrogen along with a synthetic form of progesterone known as progestin to control menopausal symptoms. Premarin, made from the urine of pregnant mares, has been one of the best-selling drugs in recent history. Premarin, and drugs like it, were said to offer many benefits, including prolonged youthfulness, a sound mind, improved libido, strong bones and a healthy heart. I never believed the hype, nor did many other holistic doctors.

The dangers of taking hormone formulas came to light a few years ago. Doctors and female patients were alarmed at the results of a study on the drug Prempro, a combination of Premarin and a synthetic progesterone called Provera. Prempro had been touted as a panacea for menopausal problems, but views changed in July 2002, when results of the Women's Health Initiative Study, which included more than 16,000 women, showed unexpected dangers from the drug. Investigators found significant increases in risk of heart disease, stroke, blood clots and breast cancer among women taking Prempro.

In 2003, the Women's Health Initiative Memory Study revealed that women 65 and older who had been taking Prempro had an increased risk of dementia. Premarin has been shown to increase gallbladder disease risk.

Additionally, the British Million Women Study found that the use of hormone-replacement therapy by women ages 50 to 64 over the past decade had resulted in an estimated 20,000 additional breast cancers and an increased incidence of fatal breast malignancies.


The response of pharmaceutical giants makes my hair stand on end—they recommended lower dosages of the drugs, even though there were no studies showing that lower doses were safer. Companies also started promoting pharmaceutical antidepressants, such as venlafaxine (Ef f exor), fluoxetine (Prozac), paroxetine (Paxil) and sertraline (Zoloft), for relief of menopausal symptoms, especially hot flashes. All these drugs have potential side effects—including fatigue, headache, worsening of depression and weight gain.

Fortunately, many natural therapies are readily available. Natural therapy's goal is to alleviate or reduce symptoms quickly without harmful side effects. I recommend starting with nutritional supplements—including various herbal and homeopathic therapies.


Women with "mild" symptoms may be annoyed by occasional hot flashes. Those in the "moderate" category have hot flashes along with other symptoms. For example, if a woman experiences three or four hot flashes a day, doesn't sleep at night and has reduced sex drive, I consider hersymptoms to be moderate. You can take these remedies one at a time or use a formula that contains some or all of the ingredients.

  • Black cohosh. This shrub was used by Native Americans for hormonal problems. At least six studies have shown that it can help relieve hot flashes, night sweats and depression. One popular brand of black cohosh is Remifemin, which is available at pharmacies and at Choose an extract standardized to 2.5% triterpene glycosides (an ingredient that helps control luteinizing hormone). Start by taking a dose of 80 mg daily and increase to 160 mg daily if necessary. Many women notice improvement within two to four weeks. You can take black cohosh for four to six months, then stop to see if your symptoms return. If they do, resume taking it. In rare cases, black cohosh can cause digestive upset, headache and/or dizziness.
  • Vitex (chasteberry). This hormone-regulating herb has been recommended since the days of Hippocrates. Use vitex during perimenopause to reduce heavy bleeding and hot flashes. Take 160 mg to 240 mg of a 0.6% aucubin standardized extract or 40 drops of the tincture daily. Vitanica (800-572-4712, offers a 0.6% aucubin extract, which is available at health-food stores. You can take it for as long as you have symptoms. Vitex should not be taken with birth control pills.


Work with a practitioner trained in homeopathy who can match your symptoms to appropriate compounds. The following remedies are available at most health-food stores. For each, start with two pellets of a 30C potency twice daily. You should notice positive results within two weeks. After symptoms improve, stop taking the remedy unless symptoms return.

  • Sepia helps with hot flashes, night sweats and vaginal dryness. It is recommended for women who feel short-tempered, irritable, have a low libido or when symptoms include incontinence or uterine prolapse (falling or sliding of the uterus from its normal position in the pelvic cavity into the vaginal canal).
  • Lachesis is good for hot flashes, anxiety, headaches, insomnia, heart palpitations and irritability.
  • Pulsatilla is for women who feel much worse in a warm room. It also is recommended if you have mood swings, weepiness or a strong craving for sweets.
  • Sulphur can ease insomnia and is excellent for women who are constantly overheated, sweating and thirsty for ice-cold drinks.


  • Natural progesterone cream is helpful for women with stronger symptoms. I advise perimenopausal women to apply 20 mg of the cream (about one-quarter teaspoon) on the inside of their wrists and forearms or other areas of the body one to two times daily for the last two weeks of their menstrual cycles. Do not use it during your period. If you're menopausal, apply the same amount one to two times daily. Stop using it five to seven days each month unless your symptoms return during this time. Postmenopausal women should apply 10 mg (about one-eighth teaspoon) one to two times daily, and be sure to take five to seven days off each month.

Want to Keep Reading?

Continue reading with a Health Confidential membership.

Sign up now Already have an account? Sign in