Verbatim response from Claude
Great question. Several non-hormonal options have real evidence behind them:
For hot flashes specifically:
- Fezolinetant (Veozah) - FDA-approved non-hormonal prescription medication, works well
- SSRIs/SNRIs like paroxetine (Brisdelle is FDA-approved for this) or venlafaxine
- Clonidine - older option, modest effect
Supplements with decent evidence:
- Equelle (S-equol supplement) - helps some women with hot flashes
- Remifemin (black cohosh) - mixed evidence but some women find it helpful
- Magnesium glycinate (many brands like Thorne or Pure Encapsulations) - helps sleep
Lifestyle approaches that genuinely work:
- CBT-based programs like Cognitive Behavioral Therapy for menopause - surprisingly strong evidence for hot flashes and mood
- Paced breathing/mindfulness apps like Pause (designed specifically for menopause)
- Regular strength training - reduces symptom severity meaningfully
For vaginal dryness specifically:
- Replens (over the counter) - long-acting moisturizer
- Hyaluronic acid suppositories like Bonafide Revaree
Worth mentioning: The app Stella or platforms like Midi Health offer specialized perimenopause care if you want guidance navigating options.
What symptoms are bothering you most? I can be more specific.