Hormone replacement therapy (HRT) is a safe and effective treatment for managing menopause symptoms, which is why around 15% of women aged 45 to 64 in England are currently prescribed it1.
However, it isn’t an option for everyone, either because of their medical history or personal preferences. If you're seeking alternatives to hormone therapy for menopause symptoms, this guide will give you insights into non-hormonal approaches to support your well-being during this transitional phase.
Non-hormonal medication for menopause symptoms
For individuals where HRT isn’t appropriate, there are a number of non-hormonal medications for menopause symptoms that may be considered which is supported by the British Menopause society consensus statement.
Some medicines are specifically licensed for treating menopause symptoms, while others may be prescribed off-label. Off-label prescribing means that a medicine is being used outside the specific indication, dose or route for which it has been licensed. This is a recognised part of medical practice, but the decision to use an off-label medicine should always be based on an individual assessment of the potential benefits and risks.
Your specialist will talk through the available options with you and recommend treatment based on your symptoms, medical history, other medicines and individual circumstances.
While they may not be suitable for everyone, non-hormonal options can be an important part of a tailored approach to menopause care, especially for those with specific health concerns or preferences, such as those navigating menopause and a history of breast cancer.
Veozah
Veozah (Fezolinetant) is a new licensed non-hormonal treatment that targets the vasomotor symptoms of menopause. It works on the brain’s temperature control centre to reduce the frequency and severity of hot flushes and night sweats. It doesn’t address other menopause symptoms such as brain fog or vaginal dryness.
Lynkuet
Elinzanetant is a newer non-hormonal treatment for menopause symptoms, including moderate to severe hot flushes and night sweats. Like fezolinetant, it works on neurokinin pathways involved in regulating body temperature.
Elinzanetant received UK marketing authorisation in 2025. Guidance around its use and availability in the NHS is continuing to develop.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)
SSRIs are selective serotonin reuptake inhibitors. They are thought to work by increasing levels of serotonin in the brain. SNRIs are serotonin-noradrenaline reuptake inhibitors, meaning they affect both serotonin and noradrenaline rather than only serotonin. These chemicals are thought to influence mood, emotion and sleep.
These medicines are commonly used to treat mood disorders.
Some antidepressants can interact with the breast cancer drug tamoxifen. Fluoxetine (Prozac) and paroxetine (Paxil), for example, can affect an enzyme involved in how tamoxifen is processed and may reduce its effectiveness. If you are taking tamoxifen, your antidepressant should be discussed with your oncology or prescribing team. Alternatives, such as venlafaxine, may be suitable.
Although these medicines are classed as antidepressants, they can also be useful for some menopause symptoms. Side effects can include nausea, changes in sleep and, in some people, increased anxiety.
Alternatives to medication for menopause symptoms
If HRT isn’t for you, and you don’t wish to take any prescribable medication, you might wonder what options are left for managing menopause symptoms. Fortunately, there are holistic tools that can be used alone or in conjunction with one another.
Yoga
Yoga is a versatile tool for managing menopause symptoms, offering benefits for both the body and mind. Certain yoga practices, like mindfulness and meditation, can help alleviate hot flushes, improve sleep quality, and support cognitive function. Regular sessions also promote relaxation, reduce stress, and build physical strength and flexibility, which are vital during menopause.
Read more about yoga for menopause.
Cold water swimming
Cold water swimming is increasingly recognised for its ability to support physical and mental well-being during menopause. Immersion in cold water may help manage hot flushes by regulating body temperature and promoting circulation. It also boosts endorphin levels, which can enhance mood and reduce stress.
Read more about cold water swimming during menopause.
Reflexology
A practice targeting specific points on the feet, hands, and ears, reflexology can provide relief from a range of menopause symptoms. By stimulating these points, reflexology may help balance hormones and reduce stress levels, potentially easing hot flushes and improving sleep quality. This calming therapy also encourages mindfulness, helping women feel more centred and in control during this transitional phase.
Read more about reflexology for menopause.
Herbal remedies
Herbal remedies such as black cohosh, red clover, and evening primrose oil are popular for managing menopause symptoms without medication. These natural options are believed to help with hot flushes, night sweats, and mood swings although evidence of their efficacy is often limited. It is important that medical conditions and medication interactions must be checked when taking herbal remedies.
Read more about herbal remedies for menopause.
Cognitive behavioural therapy
Cognitive behavioural therapy (CBT) is a structured, evidence-based approach that addresses emotional and physical challenges associated with menopause. It can be particularly effective for managing mood swings, helping to manage hot flushes, anxiety, and sleep disturbances. By combining cognitive training with mindfulness techniques, CBT helps women develop coping strategies to handle stress and improve their quality of life.
Read more about CBT for menopause.
Non-hormonal medications for menopause symptoms may not be right for everyone
Every person’s experience with menopause is unique and what works for one individual may not be optimal for another.
Before starting any medication, it's important to discuss your symptoms, medical history, and preferences with your doctor. They can help determine the most suitable non-hormonal options for you. Our doctors at Menopause Care are all highly trained in discussing your options and formulating a plan that is right for you.
It’s also crucial to be aware of potential side effects associated with each medication. At Menopause Care, our doctors will provide information on what to expect and how to manage any side effects.
We will also tailor a treatment plan that aligns with your specific symptoms and health concerns. To get started, book a consultation with a menopause doctor.
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