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.
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