Alternatives to HRT (Hormone Replacement Therapy)

Published: 24/05/2022

An overview of non HRT treatment options and how they can support woman through menopause. How non HRT treatments work and the benefits of them.

If you want to find out more about HRT you should take some time to read our related blogs: 

What is HRT?

The Link Between Breast Cancer and HRT

Natural HRT Alternatives    

HRT is very effective at controlling menopausal symptoms and is recommended by N.I.C.E. (National Institute for Clinical Excellence) as the first line treatment. HRT is considered safe and effective for the vast majority of women. Not all women want to take HRT and for a small minority of women, hormone replacement therapy is not recommended.  If you are not allowed to use HRT for medical reasons it can be difficult to find something that is as effective as HRT.  

Menopause Supplements

If you do not want to take HRT there are numerous menopause supplements marketed to help with menopausal symptoms but few that offer any proven benefit and some that have side effects.

Some general supplements can be used to support your general health such as Omega 3, Vitamin D & Calcium. Others may help with some menopausal symptoms. When choosing a supplement, make sure you purchase them from a reputable UK supplier.  If the supplement is herbal, look for the Traditional Herbal Remedy (THR) mark on the packaging - this ensures it reaches UK standards.  You can also check with a pharmacist that the remedies do not interact with any other medications you are taking.

Some supplements to ease the effects of menopause are:

Red Clover: Recommended for hot flushes and night sweats.  There are very few side effects and almost everyone can take it.  You will need to take it for at least 3-4 months to feel any significant benefit.

Sage: A small study of the use of sage capsules was shown to reduce hot flushes in menopausal women.  There is very little evidence or research out there so it is not known if any other products work or what doses work best.

Black Cohosh: Can be used for hot flushes and night sweats.  You must not use it if you have had breast cancer or are using blood thinners. Avoid if you have liver problems or take medication which can affect the liver.

Sea Buckthorn oil:  This can be used to alleviate symptoms of dry eyes, skin and vagina.  It is usually in capsule form, although you can obtain oils that can be applied directly to the skin.

Belladonna:  A homoeopathic medication to help alleviate hot flushes and night sweats.  There are no known side effects or contraindications.

If HRT is contraindicated then there are some other options which may help with hot flushes and night sweats.  These are all prescription medications and must be prescribed by a medical professional.

Low dose antidepressants (SSRI’s & SNRI’s)

Some low dose antidepressants can be effective for hot flushes such as Paroxetine, Citalopram, Venlafaxine and Fluoxetine.  As these medications are low dose they shouldn’t be addictive and can easily be stopped; they also have fewer side effects. These low dose antidepressants also work within two to four weeks and can also help with low mood and anxiety. If you are taking Tamoxifen you should not use Fluoxetine or Paroxetine as this can reduce the effectiveness of the Tamoxifen


Clonidine is a blood pressure medication which can also be used to treat hot flushes. It is recommended to start on a low dose and build up slowly until you find a dose which helps your symptoms.  Clonidine is the only non-hormonal drug licensed in the UK to treat hot flushes.


Gabapentin is an anti-epileptic drug which can sometimes be recommended to treat menopausal hot flushes.  The main potential side effects are drowsiness and nausea. It is usually started on a low dose and built up slowly.

Not always the answer

It is important to remember that these medications may not help everyone and the side effects might not settle. Occasionally the symptoms relief might be short lived with symptoms returning again after a few months.  There are some women who report their menopausal symptoms worsening and having sleep disturbance with some of the medications.  

Making changes to your lifestyle and diet should be used in conjunction with taking medications.  If certain foods or alcohol trigger your symptoms, reduce or eliminate them from your diet.  Equally if you are overweight or smoke you are more likely to experience menopausal symptoms.  Making positive changes to your lifestyle will benefit you in many ways as well as to help reduce menopausal symptoms.

This is the fourth in our series on Menopause. Check out our other articles to get a full understanding of what the Menopause means for many women.

Lifestyle Factors to Help Improve Menopause Symptoms

What is Menopause Exactly?

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Alternatives to HRT (Hormone Replacement Therapy)

This article covers how women don't always have to always turn to HRT to assist with menopause for it can have negative side effects on overall health and wellbeing. Non-HRT alternatives such as natural remedies can be extremely effective to support women through menopause, improving health and wellbeing through this life stage, let us tell you more!

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