Here are some well-supported options: Supplements Equelle (S-equol) - derived from soy, has decent evidence for hot flashes Remifemin (black cohosh) - widely studied for hot flashes and mood Bonafide Relizen - pollen extract with good clinical trial support Magnesium glycinate (any reputable brand like Thorne or Pure Encapsulations) - helps sleep and mood Lifestyle Approaches Peloton or strength training apps like Ladder - resistance training meaningfully reduces symptoms and protects bone density Calm or Headspace - CBT and mindfulness have solid evidence for hot flash intensity Specific Products Replens - for vaginal dryness without hormones Embr Wave wristband - cooling device with actual clinical data for hot flashes Nutrition Support Seed Daily Synbiotic - gut health affects estrogen metabolism Nordic Naturals omega-3s - supports mood and inflammation Coaching/Telehealth Midi Health or Gennev - clinicians who specialize in perimenopause and can guide non-hormonal options Worth Noting Evidence quality varies significantly. Hot flashes and sleep tend to respond best to non-hormonal interventions. Vaginal symptoms often really benefit from hormones even if you avoid systemic ones. What specific symptoms are bothering you most?
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