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

ClaudediscoveryCollected Jul 6, 2026, 07:52 UTC

Verbatim response from Claude

Managing Hot Flashes & Sleep at 47

You're likely in perimenopause, and there are good options across a spectrum:

Medical Treatments (Most Effective)

Hormone Therapy (HRT/MHT)

  • Estradiol patches (like Vivelle-Dot or Climara) + progesterone (Prometrium) - considered the gold standard for hot flashes
  • Talk to your doctor or a menopause specialist - find one at menopause.org (NAMS provider finder)

Non-Hormonal Rx Options

  • Veozah (fezolinetant) - FDA-approved specifically for hot flashes (2023)
  • Brisdelle (paroxetine) - low-dose antidepressant approved for hot flashes

Sleep-Specific Support

  • Magnesium Glycinate (brands: Natural Calm, Thorne) - many women find this helpful
  • CBT-I (Cognitive Behavioral Therapy for Insomnia) - highly effective; try the app Sleepio

Lifestyle/Supplement Support

  • Remifemin (black cohosh) - some evidence for hot flashes
  • Relizen (pollen extract) - non-hormonal, decent studies

Best First Step

👉 Book with a NAMS-certified menopause specialist or try Midi Health or Alloy (telehealth platforms specializing in menopause)

Would you like more detail on any of these options?

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