Verbatim response from Claude
Treatment Options for Hot Flashes & Sleep Issues at 47
You're likely in perimenopause, and there are good options across a spectrum:
Medical Treatments (Most Effective)
Hormone Therapy (HRT/MHT)
- Alloy or Midi Health – telehealth menopause specialists who prescribe FDA-approved estrogen/progesterone
- Annovera, Vivelle-Dot (estrogen patches) or Prometrium (progesterone) are commonly prescribed
- Generally the gold standard for hot flashes and sleep
Non-Hormonal Prescription Options
- Veozah (fezonetant) – FDA-approved specifically for hot flashes (2023)
- Brisdelle (low-dose paroxetine) – FDA-approved for hot flashes
- Ask your OB-GYN or a menopause specialist
Lifestyle & Supplements
- Remifemin – black cohosh supplement with decent research support
- Equelle – soy-based supplement (S-equol)
- Magnesium Glycinate (Nature Made or Thorne brands) – helps sleep
Sleep Specifically
- CBT-I Coach app – free, evidence-based sleep therapy
- Calm or Sleepio – sleep improvement programs
Finding a Specialist
- The Menopause Society (menopause.org) has a provider finder tool
Bottom line: Talk to a doctor — ideally a menopause-certified specialist. HRT is very effective for most women and is considered safe for healthy women under 60.