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I am 47 with hot flashes and terrible sleep. What are my treatment options?

ClaudediscoveryCollected Jul 31, 2026, 09:41 UTC

Verbatim response from Claude

Treatment Options for Hot Flashes & Sleep Issues (Perimenopause)

Medical Treatments (Most Effective)

Hormone Therapy (HRT/MHT)

  • Vivelle-Dot or Climara (estrogen patches) – highly effective for hot flashes
  • Bijuva – combined estrogen/progesterone pill
  • See your OB/GYN or a menopause specialist – the Menopause Society (menopause.org) can help find a certified provider

Non-Hormonal Rx Options

  • Veozah (fezolinetant) – newer FDA-approved drug specifically for hot flashes
  • Effexor (venlafaxine) – antidepressant that also reduces hot flashes

Over-the-Counter & Lifestyle

Supplements

  • Remifemin (black cohosh) – most studied herbal option
  • Equelle (S-equol) – plant-based, some evidence for hot flashes
  • Nature Made Magnesium Glycinate – can help with sleep

Sleep Aids

  • Natrol Melatonin – start low (0.5–1mg)
  • Calm app or CBT-I Coach app – cognitive behavioral therapy for insomnia

Telehealth Options

  • Midi Health – specializes in menopause care
  • Alloy or Evernow – online menopause hormone prescribing

I'd strongly recommend consulting a doctor first, as hormone therapy is the gold standard and requires a prescription. Would you like more detail on any option?

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