Natural Menopause Remedies - Menopause without HRT
Updated: Sep 4
There is certainly no shortage of menopause information out there.
You may have read books, searched the internet, listened to podcasts or asked friends what worked for them.
With so much conflicting menopause advice, it can be difficult to know what's actually worth trying.
But there are lots of ways you can support your health during perimenopause and menopause.
And taking a natural menopause approach doesn't always mean you have to choose between natural solutions and HRT.
I'm a strong advocate for HRT when it's appropriate. HRT can be an incredibly effective treatment for many menopause symptoms and can offer important health benefits too.
But it’s only one part of the picture.
Nutrition, exercise, sleep, stress management and looking after your overall health are important whether you take HRT or not.
Supplements and other approaches also have a role to play, depending on your individual circumstances.
So in this guide, we'll look at some of the natural menopause solutions, remedies and lifestyle changes that may help you feel better and support your health through menopause, as well as where HRT fits into the picture.
My aim isn't to tell you what you should do.
It's to give you reliable information so that you can make informed choices about your menopause and find the combination of support that's right for you.
Discover my 5 foundations to help you feel more in control of your menopause. Simple, evidence-based guidance on nutrition, lifestyle, sleep, stress and everyday wellbeing.
What does natural menopause support actually mean?
The word natural gets used a lot when we're talking about menopause but it can mean very different things to different people.
For me, natural menopause support is about looking at the whole picture of your health and considering the things you can do to support your body and wellbeing alongside any medical treatment you choose.
Some of these things can help with specific menopause symptoms, while others are more about protecting your long-term health and wellbeing.
And that's an important distinction.
Not every natural remedy will make your hot flushes disappear, and no supplement can replace a healthy lifestyle or appropriate medical care.
At the same time, you don't need to wait until your menopause symptoms become unbearable before you start looking after yourself.
Small, sustainable changes can make a meaningful difference, and they can sit alongside HRT if you choose to use it.
The key is to look at the evidence, understand the potential benefits and limitations of different approaches, and choose what makes sense for you.
You can find out more about my approach to menopause health here:
Natural Menopause Supplements: What Can Actually Help?
There are hundreds of products marketed specifically at women in perimenopause and menopause, promising everything from fewer hot flushes to better sleep, improved mood and easier weight management.
But natural doesn't automatically mean effective…or safe.
Some supplements can be useful when you have a genuine nutritional need, while the evidence for others is much less convincing. Some can also interact with medications or aren't suitable for everyone.
So rather than taking a long list of supplements just in case”, I prefer to start with what your body actually needs.
Vitamins and minerals
A balanced diet should provide most of the nutrients you need, but there are some nutrients that deserve particular attention during menopause.
Vitamin D is important for bone health, muscles and the normal function of the immune system. In the UK, vitamin D supplementation is commonly recommended during the autumn and winter months, although individual requirements can vary.
Calcium is essential for maintaining healthy bones. It's best to get calcium from food where possible, with dairy products, fortified alternatives, leafy green vegetables and some fish among the sources you can include in your diet.
Magnesium is involved in hundreds of processes in the body and is often promoted for sleep, relaxation and muscle function. However, more isn't necessarily better, and supplementation isn't automatically going to solve sleep problems.
Omega-3
Omega-3 fatty acids are important for overall health and are found naturally in oily fish such as salmon, sardines and mackerel.
If you don't eat oily fish, an omega-3 supplement may be something to consider, depending on your diet and individual circumstances.
Herbal menopause supplements
You'll also find plenty of herbal supplements marketed specifically for menopause, including products containing black cohosh, red clover, sage and other plant extracts.
Some women report finding these helpful for particular symptoms, but the evidence varies considerably between products and ingredients. “Natural” is not the same as “proven”, and herbal products can still have side effects or interact with medicines.
If you're considering a herbal menopause supplement, particularly if you take other medication or have an existing health condition, it's worth discussing it with your pharmacist or healthcare professional first.
What about phytoestrogens?
Phytoestrogens are naturally occurring plant compounds found in foods such as soybeans, tofu, tempeh and flaxseeds.
They're sometimes described as “natural oestrogen”, but that's an oversimplification. They are not the same as the oestrogen produced by your body or the oestrogen used in HRT.
There is some evidence that a diet containing phytoestrogen-rich foods may have benefits for health and may help some women with certain menopause symptoms.
My approach to supplements
I'm not against supplements at all. In fact, often they can be a really useful addition to your menopause toolkit.
But I don't believe you need a cupboard full of supplements to have a healthy menopause.
Start with your diet, your lifestyle and your individual needs. Then consider whether a supplement has a clear purpose.
And remember that supplements are not a substitute for medical care. If your symptoms are significantly affecting your quality of life, there are effective medical treatments available, including HRT and non-hormonal options.
The goal isn't to take as many supplements as possible. It's to work out what your body actually needs.
A menopause supplement I rate
If you're looking for a menopause-specific supplement, Nu Mind Menopause Support is one product I personally recommend. It combines a range of nutrients and ingredients aimed at supporting women through menopause.
As with any supplement, it's important to look at the ingredients rather than assuming that every menopause supplement is right for you. Check whether it is appropriate alongside any medication you're taking, and remember that supplements should complement, not replace, a healthy diet and appropriate medical care.
Nutrition for Menopause
What you eat during perimenopause and menopause can have a much bigger impact on how you feel than you might realise.
A healthy menopause diet is about giving your body the nutrients it needs to support energy, muscle, bone health, heart health, brain health and overall wellbeing.
I like to keep it simple: build your meals around protein, fibre, plants and healthy fats.
Prioritise protein
Protein becomes particularly important as we get older because we naturally start to lose muscle mass. Maintaining muscle helps support strength, mobility and metabolic health.
Include a source of protein at each meal, such as eggs, Greek yoghurt, fish, chicken, lean meat, tofu, beans, lentils or other pulses.
If breakfast is usually just coffee and toast, for example, try adding eggs, Greek yoghurt or another protein-rich option.
Don't forget fibre
Fibre supports your digestive health and helps keep you feeling fuller for longer. It can also help support healthy blood glucose and cholesterol levels.
Aim to include plenty of vegetables, fruit, wholegrains, beans, lentils, nuts and seeds throughout the day.
Include healthy fats
Healthy fats are an important part of a balanced menopause diet. Foods such as extra virgin olive oil, avocado, nuts, seeds and oily fish provide fats that support your overall health.
There's no need to be afraid of fat. Choose the right types and get the balance right.
You can read more about eating well during menopause in my guide, where I go into much more detail about what to eat and why.
And if you want practical recipes that make putting this into practice easier, take a look at my Menopause Recipe Book and Meal Plan.
Sleep and Menopause
If you've ever spent the night wide awake at 2am wondering why you're suddenly unable to sleep, you'll know how frustrating menopause-related sleep problems can be.
Changes in hormones can affect sleep, while night sweats and hot flushes can wake you during the night.
Stress, anxiety and an overactive mind can make things even harder.
And poor sleep can have a knock-on effect on almost everything else - your mood, concentration, energy, appetite and ability to cope with everyday life.
There are some simple things you can try to give yourself the best possible chance of getting a good night's sleep.
Create a ‘sleep-friendly’ environment
Keeping your bedroom cool can be particularly helpful if you're experiencing night sweats or hot flushes. Breathable bedding and nightwear can also make you more comfortable.
Try to keep your bedroom dark and quiet and make your bed a place that's associated with sleep rather than scrolling through your phone or working.
Develop a consistent routine
Going to bed and getting up at roughly the same time each day can help establish a regular sleep pattern.
A relaxing wind-down routine can also signal to your body that it's time to switch off. This could include reading, gentle stretching, breathing exercises, meditation or simply putting your phone away for the evening.
Look at your daytime habits too
Sleep isn't just about what happens at bedtime.
Regular physical activity, getting outside during the day and managing stress can all support better sleep.
It's also worth considering whether caffeine or alcohol could be affecting your sleep, particularly if you're waking during the night.
And don't underestimate the importance of addressing the underlying cause of your sleep problems.
If hot flushes, night sweats, anxiety or other menopause symptoms are repeatedly waking you up, improving your bedtime routine may only take you so far. Treating the symptoms themselves can sometimes make a much bigger difference.
I've written more about getting better sleep during menopause in How to Sleep in Menopause, including some practical steps you can try.
Exercise and Movement
Regular movement is one of the most powerful ways to support your health during perimenopause and menopause, and you don't need to become a marathon runner to benefit.
Exercise can help support muscle strength, bone health, cardiovascular health, mood, sleep and overall wellbeing. It can also help you maintain muscle mass and physical function as you get older.
The key is to find movement you enjoy and can realistically keep doing. You don't have to exercise perfectly, you just need to keep moving in ways that work for you.
Make strength training a priority
As oestrogen levels decline during menopause, we become more vulnerable to loss of muscle mass and strength and reductions in bone density. This makes resistance training particularly important during midlife and beyond.
Strength training can help maintain and build muscle, support bone health, improve balance and help you stay strong and independent as you age.
You can use weights, resistance bands, gym equipment or your own body weight. And if you're new to strength training, start where you are and build gradually. You don't need to lift heavy weights from day one.
If you're unsure where to start, working with a qualified professional can help you learn good technique and create a programme that's appropriate for you.
You could also start by trying an online session such as Joe Wicks’ Menopause workouts.
Include weight-bearing movement
Weight-bearing activities such as brisk walking, dancing, jogging and stair climbing can also help support bone health.
Ideally, your week will include a combination of resistance training, weight-bearing activity and cardiovascular exercise. But don't let the idea of the “perfect” exercise routine stop you from doing anything at all.
Something is better than nothing, and you can build from there.
Don't forget everyday movement
Exercise doesn't have to mean a formal workout.
Walking, gardening, cycling, swimming, taking the stairs and simply spending less time sitting all contribute to a more active lifestyle.
And if you're exhausted or struggling with menopause symptoms, don't beat yourself up for not exercising “perfectly”. Consistency matters more than perfection.
The best exercise programme is the one you can actually enjoy and stick with.
Manage Stress and Support Your Nervous System
Perimenopause and menopause can be stressful enough without everything else life throws at you.
Hormonal changes can affect mood, anxiety, sleep, concentration and emotional resilience, while the demands of work, relationships, caring responsibilities and midlife change can add another layer of stress.
You can't always remove the things that are causing stress, but you can build habits that help your body and mind cope with it.
Build in regular recovery time
If you're constantly rushing from one thing to the next, your body doesn't get much opportunity to recover.
Simple things such as getting outside, spending time in nature, listening to music, reading, having a bath, practising slow breathing or simply doing something you enjoy can help create moments of calm in your day.
You don't need to spend an hour meditating or follow a complicated wellness routine. Even a few minutes of intentional downtime can be worthwhile.
Find ways to calm your body
When you're stressed, your body responds too. Your heart rate can increase, your breathing can become faster and your muscles may tense.
Practices such as slow breathing, mindfulness, yoga, gentle movement or relaxation exercises can help you shift out of a state of constant alertness and give your body a chance to settle.
There isn't one “right” way to do this. The most useful approach is one that feels comfortable and realistic for you.
Don't underestimate the basics
Supporting your nervous system isn't about buying another supplement or following the latest wellness trend.
Regular meals, enough sleep, movement, time outdoors, connection with other people and periods of genuine rest all contribute to your ability to cope with stress.
And if you're feeling persistently anxious, overwhelmed, low or unable to cope, don't feel that you have to manage it alone.
Talking to your GP or another appropriately qualified professional can be an important part of looking after your mental health.
And if you need a little help explaining to your husband or partner how the menopause is impacting you, I’ve written ‘A Menopause Letter to my Husband’.
Managing stress won't stop the hormonal changes of menopause, but it can help you build greater resilience and capacity to cope with everything that this stage of life can bring.
Natural Remedies for Common Menopause Symptoms
If you decide not to use HRT, or HRT isn't suitable for you, that doesn't mean you have to simply put up with difficult menopause symptoms.
There are a range of lifestyle, psychological and non-hormonal treatment options that can help. The most appropriate approach will depend on your symptoms, your health and your individual circumstances.
Hot flushes and night sweats
Hot flushes and night sweats are among the most common symptoms of menopause.
Keeping your bedroom cool, wearing layers, choosing breathable clothing and identifying your personal triggers can make a difference. Some people find that reducing alcohol, caffeine or spicy foods helps, although triggers vary from person to person.
Regular exercise and maintaining a healthy weight may also help some women.
Cognitive behavioural therapy (CBT) has also been shown to help with the impact of hot flushes and night sweats, as well as associated sleep difficulties and anxiety.
If symptoms are significantly affecting your quality of life, there are also non-hormonal prescription treatments that your healthcare professional may be able to discuss with you.
Vaginal dryness and urinary symptoms
Vaginal dryness, irritation, discomfort during sex and changes in urinary symptoms can be particularly troublesome during menopause.
Simple measures such as vaginal moisturisers and lubricants can help with dryness and discomfort. Staying hydrated and seeking advice about pelvic-floor health may also be useful.
It's worth knowing that local vaginal oestrogen is different from systemic HRT.
It is used directly in the vagina to treat genitourinary symptoms and involves much lower systemic absorption than HRT used to treat symptoms throughout the body.
If you're avoiding systemic HRT, don't assume that you can't use local vaginal oestrogen. It's worth discussing with your GP or another menopause healthcare professional to see whether it's appropriate for you.
Mood, anxiety and emotional wellbeing
Menopause can coincide with significant changes in mood, anxiety and emotional wellbeing. Hormonal changes, poor sleep and the pressures that often come with midlife can all contribute.
Looking after the foundations we've already discussed (sleep, movement, nutrition, connection and stress management) can provide an important base.
Psychological approaches such as CBT can also be helpful, particularly if anxiety, low mood or menopause symptoms are affecting your day-to-day life.
Antidepressants and SSRIs
Antidepressants can help manage mood swings and anxiety.
Current UK Guidelines are that these should not be a first-line treatment for low mood in perimenopause or menopause.
Low mood in menopause is highly responsive to HRT.
Low mood is however different from clinical depression which is a completely different diagnosis. The course of treatment is different too.
If you think you might be suffering from depression then it is imperative that you speak to your doctor.
If you're struggling with persistent anxiety, depression or feeling unable to cope, please don't assume that you simply have to accept it as “part of menopause”.
You deserve proper support.
Brain fog and concentration
Brain fog can make it harder to concentrate, remember things or find the right words, and it can be incredibly frustrating.
There isn't a single treatment for menopause-related brain fog, but improving sleep, managing stress, eating regularly, getting enough protein and fibre, and staying physically active can all support your overall brain and metabolic health.
It's also important to consider other possible contributors.
Poor sleep, stress, anxiety, medication, nutritional deficiencies and other health conditions can all affect concentration and memory.
If symptoms are persistent or particularly troublesome, talk to your healthcare professional rather than automatically assuming they're caused by menopause.
Joint and muscle aches
Aches and stiffness are also common around menopause.
Regular movement, strength training and maintaining muscle can help you stay physically strong and mobile. Starting gently and gradually increasing what you do is often more sustainable than pushing yourself through an intense exercise programme.
If you have persistent, severe or unusual pain, however, it's important to get it assessed rather than automatically putting it down to menopause.
You don't have to choose just one approach
Managing menopause without HRT doesn't have to mean relying on lifestyle changes alone.
You might combine nutrition, exercise, stress management and sleep support with psychological therapies or non-hormonal medical treatments, depending on your symptoms.
And remember that choosing not to take HRT is a personal decision, but it isn't a decision you have to make once and never revisit.
Your circumstances and preferences can change, and you can always discuss your options with a healthcare professional.
Natural menopause book: one of my favourite recommendations
If you're looking for a practical guide to changing your diet and lifestyle during menopause, Karen Newby's The Natural Menopause Method is one of the books I always recommend.
Topics included: What is going on in my body?; How to get rid of that stubborn weight gain; How to sleep better (and deal with night sweats); How to balance mood and curb sugar cravings; How to combat a foggy head; What to eat: food essentials for your perimenopausal store cupboard.
HRT Is Still an Option
I'm not someone who believes women should be expected to manage menopause naturally at all costs.
If HRT is appropriate for you, it can be one of the most effective tools we have for treating menopause symptoms.
Choosing not to take HRT doesn't mean that HRT is the wrong choice, and you don't have to decide that you'll never use it.
HRT can be a very effective treatment for menopause symptoms and, for many women, the benefits outweigh the risks.
It can improve symptoms such as hot flushes, night sweats, sleep problems, vaginal symptoms and menopause-related mood changes, while also helping to protect against the loss of bone density that occurs after menopause.
For some women, HRT can make a significant difference to their quality of life.
HRT isn't one-size-fits-all
There are different types of HRT, including different forms of oestrogen and progesterone, and different ways of taking them. What works well for one person may not work for another.
Some women also need to consider other health conditions, medications or their individual risk factors when deciding whether HRT is appropriate.
If you've been told in the past that you can't take HRT, or you've simply assumed that it isn't an option for you, it's worth having an up-to-date conversation with a healthcare professional who understands menopause.
Your options may be different from what you think.
And if you've tried HRT before and it didn't work for you, that doesn't necessarily mean that all HRT will be unsuitable.
Sometimes changing the type, dose, route or progesterone component can make a huge difference.
What about vaginal oestrogen?
If your main symptoms are vaginal dryness, irritation, discomfort during sex or urinary symptoms, local vaginal oestrogen is another option to discuss with your healthcare professional.
Unlike systemic HRT, local vaginal oestrogen is used directly on the vulva and in the vagina and has minimal absorption into the bloodstream.
It can be particularly useful for genitourinary symptoms of menopause and may be appropriate for many women who don't want or need systemic HRT.
If you'd like to understand more about how HRT works, the different types available, its benefits and risks, and who may be suitable for treatment, read my guide to HRT in menopause.
When Should You Speak to Your Doctor?
Managing menopause without HRT doesn't mean you have to manage everything on your own.
Lifestyle changes can be incredibly helpful, but there are times when it's important to speak to your GP or another healthcare professional, particularly if symptoms are severe, persistent, unusual or having a significant impact on your life.
Don't assume every symptom is menopause
Menopause can cause a wide range of symptoms, but that doesn't mean every change you experience is automatically caused by your hormones.
If a symptom is new, persistent, getting worse or particularly concerning, it's worth getting it checked rather than assuming you just have to live with it.
This is particularly important for symptoms such as unexplained weight loss, persistent or unusual pain, significant changes in your health or wellbeing, or symptoms that don't fit your usual menopause pattern.
Get unusual bleeding checked
Changes to your periods are common during perimenopause, but very heavy bleeding, bleeding between periods, bleeding after sex or any bleeding after menopause should be discussed with your healthcare professional.
Don't simply assume that unusual bleeding is ‘just menopause’.
Ask for help if symptoms are affecting your life
You don't have to wait until you're at breaking point before asking for support.
If hot flushes, poor sleep, anxiety, low mood, brain fog or other symptoms are affecting your relationships, work, confidence or ability to enjoy your life, speak to your GP or another healthcare professional.
There may be treatments or support available that you haven't considered, including non-hormonal options if you don't want to take HRT or it isn't suitable for you.
And remember: your options can change
Perhaps you've decided not to take HRT because your symptoms are manageable.
Perhaps you've tried it before and didn't get on with it. Or perhaps you've never seriously considered it.
That's okay.
You can revisit your options at any point. Your symptoms, health, circumstances and preferences may change over time, and what wasn't right for you previously may not necessarily be the right answer in the future.
The most important thing is that you have the information and support you need to make decisions that are right for you.
Natural Menopause Without HRT: You Have Options
Choosing not to take HRT is a perfectly valid choice.
There are many things you can do to support your health through perimenopause and menopause, from eating well and staying active to prioritising sleep, managing stress, looking after your mental health and finding ways to manage individual symptoms.
But you don't have to do everything at once, and you certainly don't need to achieve some kind of “perfect menopause lifestyle”.
Start with the things that are most relevant to you. Small, sustainable changes can add up over time.
And remember that you don't have to choose between lifestyle changes and medical support. There are non-hormonal treatments available for some menopause symptoms, and HRT remains an effective and appropriate option for many women.
Your menopause is personal to you. What works for your friend, sister or colleague may not be right for you, and that's okay.
The most important thing is to understand your options, get good-quality information and make decisions based on your symptoms, your health, your circumstances and your preferences.
If you're feeling overwhelmed by all the information around menopause, my 1:1 menopause support can help you work through your symptoms, lifestyle, nutrition and treatment options and create a plan that feels realistic for you.
DISCLAIMER: This page does not provide medical advice; it is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek professional medical advice on any of the topics or products covered on this page.
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