If you’re a woman in your middle years, then you may already be familiar with perimenopause.
Maybe you are trying to manage symptoms or want to know more about what help is available. You are sure to have lots of questions about this milestone in your life.
Help is at hand. We’ve compiled this guide to give you the heads-up on what help is out there, explaining some of the traditional treatments and their side effects, as well as seven natural remedies for perimenopause that can help you navigate this challenging phase of your life.
What Is Perimenopause?
Perimenopause is the period before you reach menopause, the time when your menstrual cycle stops. Think of it as a transition period to prepare you for a big change in your life.
It usually takes place at any point between 40 and 50, though you may experience symptoms earlier. Its average duration is four years but can be longer.
The key marker of perimenopause is a drop in the levels of the oestrogen and progesterone that your ovaries produce. These hormones regulate your menstrual cycle and also play a vital role in pregnancy.
As you get nearer to menopause, their levels will fall dramatically.
Unfortunately, this can cause a number of undesirable symptoms including hot flashes, night sweats, breast tenderness, mood swings, fatigue, irregular periods, disrupted sleep and urinary incontinence.
If you want confirmation that you’re going through perimenopause, your doctor can take blood tests to check your hormone levels.
You’ll know when the perimenopause phase is over and you are entering menopause when you go 12 consecutive months without having a period (1).
What’s the Deal with Conventional Perimenopause Treatments?
If you’re experiencing any of the perimenopausal symptoms described above, you’ll want to know what therapies are available to help you.
Let’s take a look at conventional perimenopause treatments first. It’s worth bearing in mind that these therapies tend to use synthetic hormones and, while they can be effective, many come with unwanted side effects.
Hormone Replacement Therapy (HRT)
Hormone replacement therapy (HRT) is taking medication that replaces the female hormones that naturally decline as you progress through perimenopause.
Many women use HRT to help combat the common symptoms that come with perimenopause and menopause, reporting that it gives them a new lease of life, such as by relieving hot flashes (2).
For these reasons, many women are wary of taking HRT.
You’re probably familiar with the contraceptive pill as a method of birth control. But did you know that it can also be used to help level out your hormones and reduce the fluctuations that can lead to uncomfortable perimenopausal symptoms (7)?
The pill uses synthetic forms of the hormones progesterone (progestin) and oestrogen to achieve this. Some brands are progesterone-only, while others are a mix of the two.
If you opt for the contraceptive pill, you should be aware that you run the risk of developing high blood pressure (8). This can lead to blood clots, heart attack, or stroke.
This means that the pill is not suitable for many women, and it makes others reluctant to use it as a solution to their perimenopausal symptoms.
This prescription drug can alleviate typical perimenopausal symptoms such as hot flashes when taken as an immediate-release oral tablet. It also helps with sleep quality when taken in its extended-release form.
Just as we’ve seen with other medications, it also comes with a range of side effects, such as dizziness and unsteadiness (10). Its use is also discouraged for anyone with a history of substance abuse (11).
7 New Science-Backed Natural Remedies for Perimenopause
Now that you know a little about the side effects of traditional treatments for perimenopausal symptoms, you would be forgiven for seeking a natural alternative to help you live life to the full during this chapter of your life.
Here, we’ve highlighted seven natural remedies to help alleviate the symptoms of perimenopause. We’ll take a closer look at them in turn, explaining their benefits and how they work in harmony with nature to give you the relief you’re seeking.
Chasteberry, or Vitex agnus-castus, is a relatively new supplement, but it’s native to central Asia’s chaste trees. There is a long history of using chasteberry to help with perimenopausal symptoms because it has direct impacts on hormones like oestrogen and progesterone.
In Australia, the Royal Melbourne Institute of Technology set out to discover how effective chasteberry was on perimenopause by analysing 12 randomised trials. Eight of the 12 trials focused on perimenopause, two focused on premenstrual dysphoric disorder, and two focused on hyperprolactinaemia (an excess of the hormone prolactin, which can disrupt the menstrual cycle.
Out of these eight trials, seven of them had results that proved using chasteberry worked better for controlling perimenopause symptoms than the placebo did (13).
2. Maca Root
Maca root goes by the better-known name of Peruvian ginseng. Indigenous people of the Andes region have used maca root for centuries to help heal several common health problems.
Most commonly, there is a long history of using it for infertility, hot flashes, sleep disruptions, night sweats, and bedroom dysfunction (14).
One double-blind study took 20 women who were reporting issues with their perimenopause symptoms. These outpatients reported feeling discomfort, and many of them had night sweats or hot flashes.
The researchers split the 20 women into two groups of 10. Each group had blood tests before the beginning of the trial to measure their levels of oestrogen and progesterone.
The women in group A received 500 mg of maca root, while the women in group B received a placebo twice a day. Researchers took another blood test at the end of the study to test the women’s hormone levels.
They found that group A had far more regulated hormones than the women in group B. They reported having fewer night sweats, hot flashes, and discomfort as well (15).
3. Rhodiola Extract
Rhodiola rosea is a plant that naturally grows in the cooler mountainous regions of Europe and Asia. There are over 140 active ingredients in rhodiola extract, which is known to help your body handle stress.
People living in Russia and Scandinavia have used this plant for centuries to fight fatigue, depression, and anxiety. It has a positive impact on oxidative stress and hormonal biomarkers that can reduce inflammation and balance your hormones (16).
One Russian study demonstrated rhodiola extract’s effectiveness in helping regulate perimenopause hormone levels. In the study, 40 women who were experiencing hormone fluctuations and irregular menstrual cycles got a dose of this extract orally in tablet form or by injection once a day for two weeks.
At the end of the two weeks, 25 out of the original 40 participants had normal menstrual cycles, while 11 got pregnant (17).
4. Ashwagandha Root Extract
Ashwagandha is a shrub native to India, and it is also known as Indian winter cherry and Indian ginseng. Prized for its versatility, it has been used since ancient times in Ayurvedic medicine and for a wide variety of conditions, including depression, mood swings, and irritability.
It can also aid in weight loss and help the body adapt to stress. Additionally, ashwagandha root extract is believed to help with hormone balance and bestowing a feeling of being comfortable in one’s body.
Along with its ability to aid symptoms such as hot flashes, sleep issues, and depressive mood, it makes an ideal natural treatment for the perimenopausal woman.
This clinical evaluation (18) administered ashwagandha combined with two other Ayurvedic remedies, ashokarishta and praval pishti, to a group of 52 women suffering from a range of symptoms as described above. Around 54 per cent noticed an improvement in sleep issues, 41.41 per cent reported an improvement in their irritability, and 42.22 per cent said their dryness of private areas improved.
5. Chamomile Extract
Chamomile is a flowering plant from the daisy family that grows all around the world. It’s been used as a natural remedy since ancient times to treat a wide spectrum of complaints from digestive issues through to skin irritation and bladder problems.
It’s especially helpful to the perimenopausal woman as it can treat premenstrual tension, indigestion, and gastrointestinal inflammation associated with perimenopause, as well as sleep disorders. It also has a balancing effect on hormones.
This is robustly backed up by research. A recent extensive review (19) into how chamomile could treat premenstrual syndrome concluded that the chemical composition of the plant gives it anti-inflammatory, anti-spasmodic, anti-anxiety, and sedative qualities.
So not only does it help with some of the psychological aspects of premenstrual syndrome such as anxiety, irritability, and mood swings, it also helps with the pain associated with menstruation.
6. Rosemary Extract
This woody, fragrant herb is popular in cooking and also has an amazing range of medicinal uses.
Scientific research has found that rosemary has anti-inflammatory and antioxidant properties. These antioxidants help to cancel out the harmful effects of free radicals, lowering the risk of you developing conditions such as heart disease, diabetes, and cancer.
This also means it’s great for reducing oestrogen buildup in the body, which can lead to weight gain and menstrual problems.
Rosemary extract is an ideal supplement for perimenopausal women, helping with symptoms such as hot flashes, abdominal pain, fatigue, premenstrual syndrome, fibrocystic breasts, fibroids, endometriosis, and heavy and irregular periods.
This study (20) found that rosemary has analgesic (painkilling) properties and supported its use in treating pain, such as menstrual pain experienced during perimenopause.
7. Fennel Seed Extract
One of the more uncomfortable symptoms of perimenopause is hormonal bloating, fluid retention, and digestive issues. Help is at hand, though, in the form of fennel seed extract.
This flowering plant is used extensively in cooking for its distinctive flavour. It also has a number of properties that are invaluable to the perimenopausal woman.
Fennel is perhaps best-known for its ability to soothe digestive problems. One of its compounds has a relaxing effect on your gastrointestinal tract, which means that gas can pass through freely, thus reducing bloating.
It can also relieve pain associated with menstruation, and its extract used in cream can reduce excess hair that sometimes occurs during hormonal changes such as perimenopause.
One study (21) confirmed fennel’s place as an effective and safe treatment for many common symptoms — ranging from digestive issues and anxiety to hot flashes and sleep disorders — suffered by women approaching, undergoing, and post-menopause.
Side Effects and Safety
Fortunately, there are very few side effects associated with these natural remedies for perimenopause. The side effects that people did report were mild, and they tended to fade after a few weeks. The most common of these were nausea, headache, rash, upset stomach, and some minor spotting or bleeding.
However, to be safe, consult with your physician before you introduce any of these natural remedies for perimenopause into your diet. Your physician will be able to tell you whether or not it might interact adversely with your system or other medications you are taking.
If they give you the go-ahead, you can try and see which one works to help with your perimenopause symptoms. With these safe and effective natural treatments, you are sure to find one that will alleviate unwanted symptoms of this life-changing transition.
A personal note: If you’ve been trying dozens of HRTs, elimination diets, doctors or supplements and your body is still out of control, with emotions bursting out of you with no warning...
1. Santorno N, 2016. ‘Perimenopause: From Research to Practice,’ Journal of Women’s Health, 25(4): 332–339.
3. Anderson G, Judd H, Kaunitz A, Barad D, Beresford S, Pettinger M, Liu J, McNeeley S, Lopez A, 2003. ‘Effects of estrogen plus progestin on gynecologic cancers and associated diagnostic procedures: the Women's Health Initiative randomized trial,’ The Journal of the American Medical Association, 290(13):1739-48.
5. Heiss G, Wallace R, Anderson G, Aragaki A, Beresford S, Brzyski R, Chlebowski R, Gass M, LaCroix A, Manson J, Prentice R, Rossouw J, Stefanick M, WHI Investigators, 2008. ‘Health risks and benefits 3 years after stopping randomized treatment with estrogen and progestin’, The Journal of the American Medical Association, 299(9):1036-45.
6. LaCroix A, Chlebowski R, Manson J, Aragaki A, Johnson K, Martin L, Margolis K, Stefanick M, Brzyski R, Curb D, Howard B, Lewis C, Wactawski-Wende J, WHI Investigators, 2011. ‘Health outcomes after stopping conjugated equine estrogens among postmenopausal women with prior hysterectomy: a randomized controlled trial,’ The Journal of the American Medical Association, 305(13):1305-14.
8. Perol S, Hugon-Rodin J, Plu-Bureau G, 2019. ‘Hypertension and contraception,’ Presse Medicale, 48(11 Pt 1):1269-1283.
11. Mersfelder T, Nichols W, 2016. ‘Gabapentin: Abuse, Dependence, and Withdrawal,’ The Annals of Pharmacotherapy, 50(3):229-33.
12. ‘Chasteberry,’ National Center for Complementary and Integrative Health, https://www.nccih.nih.gov/health/chasteberry.
14. ‘Maca,’ MedlinePlus, https://medlineplus.gov/druginfo/natural/555.html.
16. ‘Rhodiola,’ National Center for Complementary and Integrative Health, https://www.nccih.nih.gov/health/rhodiola.
17. Brown R, Gerbarg P, Graham B, 2004. ‘The Rhodiola Revolution: Transform Your Health with the Herbal Breakthrough of the 21st Century,’ (excerpt), published by Rodale.
20. Raskovic A, Milanovic I, Pavlovic N, Milijasevic B, Ubavic M, Mikov M, 2015. ‘Analgesic effects of rosemary essential oil and its interactions with codeine and paracetamol in mice ,’ European Review for Medical and Pharmacological Sciences, 19(1):165-72.
21. Rahimikian F, Rahimi R, Golzareh P, Bekhradi R, Mehran A, 2017. ‘Effect of Foeniculum vulgare Mill. (fennel) on menopausal symptoms in postmenopausal women: a randomized, triple-blind, placebo-controlled trial,’ Menopause, 24(9):1017-1021