Verbatim response from Claude
Great question. Several non-hormonal options have solid evidence behind them:
For Hot Flashes/Night Sweats
- Fezolinetant (Veozah) - FDA-approved non-hormonal prescription specifically for this
- SSRIs like escitalopram (Lexapro) - prescribed off-label, genuinely effective
- Gabapentin - especially helpful for nighttime symptoms
Supplements with Reasonable Evidence
- Remifemin (black cohosh) - one of the better-studied options
- Equelle (S-equol, a soy isoflavone) - some good trial data for hot flashes
- Magnesium glycinate (many brands like Thorne or NOW Foods) - helps sleep and mood
Lifestyle Approaches That Actually Work
- Cognitive Behavioral Therapy - has solid trial evidence for hot flashes and sleep
- Sleepio - digital CBT-I program, well-researched for insomnia
- Peloton or similar cardio - regular aerobic exercise consistently reduces symptom severity
For Vaginal Symptoms Specifically
- Revaree (hyaluronic acid suppositories) - good option without hormones
- K-Y Liquibeads or Replens - longer-lasting moisturizers, not just lubricants
Worth Noting Many supplements are overhyped - the evidence varies a lot. A menopause specialist (NAMS-certified) can help you figure out what's worth trying for your specific symptoms.
What symptoms are bothering you most?