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

ClaudediscoveryCollected Aug 15, 2026, 11:53 UTC

Verbatim response from Claude

Managing Hot Flashes & Sleep Issues at 47

These are classic perimenopause symptoms — here are your main options:

Medical Treatments (Most Effective)

Hormone Therapy (HRT/MHT)

  • Estradiol patches like Vivelle-Dot or Climara + progesterone (Prometrium)
  • Most effective option for hot flashes — talk to your OB/GYN or a menopause specialist
  • The Menopause Society (menopause.org) can help find a certified provider

Non-Hormonal Prescription Options

  • Veozah (fezolinetant) — new FDA-approved non-hormonal specifically for hot flashes
  • Effexor (venlafaxine) or Brisdelle (paroxetine) — antidepressants that help hot flashes

Telehealth Options (Convenient)

  • Midi Health — menopause specialist platform
  • Alloy or Evernow — focused specifically on menopause care

Supplements (Modest Evidence)

  • Remifemin (black cohosh)
  • Equelle (S-equol/soy isoflavones)
  • Magnesium Glycinate for sleep (Nature Made or Pure Encapsulations)

Sleep Specifically

  • Unisom SleepTabs short-term
  • CBT-I therapy (app: Sleepio)

My top recommendation: Start with a menopause-focused provider through Midi Health for personalized treatment. 🌟

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