Researchers reviewed studies about how women can manage mild-to-moderate menopause symptoms without using hormone therapy. They found that lifestyle changes like exercise and eating better, along with over-the-counter supplements and talk therapy, can really help. While some natural products work better than others, the good news is that women have options. The study suggests a step-by-step approach: try lifestyle changes first, then over-the-counter products if needed, and finally consider prescription medications only if nothing else works. This gives women more choices for feeling better during menopause.

The Quick Take

  • What they studied: Whether women going through menopause can manage their symptoms using non-prescription options like exercise, diet, supplements, and therapy instead of hormone medications.
  • Who participated: This was a review of many different studies about women with mild-to-moderate menopause symptoms who wanted to avoid or couldn’t use prescription hormone therapy.
  • Key finding: Lifestyle changes, certain over-the-counter supplements, and especially cognitive behavioral therapy (a type of talk therapy) can help reduce menopause symptoms. The strongest evidence supports talk therapy, while supplements show mixed but promising results.
  • What it means for you: If you’re experiencing menopause symptoms and want to avoid prescription medications, you have several evidence-based options to try first. Start with exercise and diet improvements, consider certain supplements, and talk to your doctor about therapy. However, always check with your healthcare provider before starting supplements, especially if you take other medications.

The Research Details

This was a systematic review, which means researchers looked at and summarized findings from many different studies about menopause symptom management. They examined research on three main approaches: lifestyle changes (like exercise and better eating), over-the-counter products (supplements and herbal remedies), and behavioral therapies (like talk therapy). By combining results from multiple studies, they could see which approaches had the strongest evidence supporting them.

The researchers looked at different types of studies, including observational studies (where researchers watch what people do) and randomized controlled trials (where people are randomly assigned to try different treatments). This mix of study types helped them understand both what works in real life and what works in controlled research settings.

They focused specifically on women with mild-to-moderate symptoms who either couldn’t take hormone therapy or preferred not to. This is important because it helps women understand their options when prescription medications aren’t right for them.

This research matters because many women going through menopause want alternatives to prescription hormone therapy due to health concerns, personal preference, or medical reasons. By reviewing all the available evidence together, researchers could give women and doctors a clear picture of what actually works. This helps women make informed decisions about their health and gives them confidence that non-prescription options have scientific support behind them.

This is a systematic review, which is a strong type of research that looks at many studies together. However, the researchers noted that much of the evidence for supplements comes from lower-quality studies. The strongest evidence comes from randomized controlled trials (the gold standard of research), and they found the best support for behavioral therapy. The review also points out that supplement quality and dosage vary between products, which makes it harder to know exactly what will work. Readers should know that while this review is comprehensive, individual supplements may need more research.

What the Results Show

The research found that lifestyle changes—specifically more exercise and eating a healthier diet—can help reduce menopause symptoms and improve overall health. While the evidence for these changes comes mainly from smaller or observational studies, the benefits are clear and have no negative side effects.

Over-the-counter supplements and herbal products are very popular with women going through menopause. Some of these products, like certain plant-based remedies, have shown promise in reducing hot flashes and night sweats. However, the evidence is mixed, meaning some studies show they work while others don’t. This happens partly because different products have different ingredients and strengths, making it hard to compare them fairly.

The strongest evidence came for behavioral therapy, particularly cognitive behavioral therapy (CBT), which is a type of talk therapy. Multiple high-quality studies showed that this therapy significantly helps with menopause symptoms like hot flashes, mood changes, and sleep problems. This is important because it’s a non-medication option with strong scientific backing.

The researchers recommend a three-step approach: first try lifestyle changes, then consider over-the-counter products if needed, and finally use prescription medications only if other options haven’t worked and the patient agrees.

The review found that education about menopause itself is really important. When women understand what’s happening in their bodies and what to expect, they often feel better and can manage symptoms more effectively. The research also highlighted that many women are already using over-the-counter products, so doctors should ask about them and help women choose safe, evidence-based options. Additionally, the researchers noted that some supplements can interact with other medications or may not be safe for women with certain health conditions like breast cancer, so medical supervision is important.

This research builds on previous studies by bringing together evidence from many different sources. Earlier research showed that hormone therapy works well but isn’t right for everyone. This review confirms that non-prescription options are worth trying and have scientific support, which is newer information. The strong evidence for behavioral therapy is particularly important because it’s a newer finding that wasn’t as well-established in older research. This review also updates what we know about supplements by looking at the most recent studies.

The main limitation is that evidence for supplements is often weak or mixed. Many supplement studies are small or not well-designed, making it hard to know for sure if they work. The quality and ingredients of supplements vary widely between brands and products, so what works in one study might not work in another. Additionally, this review couldn’t include all possible supplements because there are so many. The researchers also noted that more research is needed on long-term safety and effectiveness of these products. Finally, individual women respond differently to treatments, so what works for one person might not work for another.

The Bottom Line

If you have mild-to-moderate menopause symptoms and want to avoid prescription medications: (1) Start with lifestyle changes—aim for at least 150 minutes of exercise per week and eat a diet rich in fruits, vegetables, and whole grains (high confidence). (2) Consider over-the-counter supplements that have some research support, but talk to your doctor first, especially if you take other medications (moderate confidence). (3) Try cognitive behavioral therapy or counseling, which has strong evidence for helping with symptoms (high confidence). (4) Get education about menopause to better understand what you’re experiencing (high confidence). Only move to prescription medications if these approaches aren’t enough and after discussing with your doctor.

These findings are most helpful for women experiencing mild-to-moderate menopause symptoms who want to avoid or can’t take hormone therapy. Women who prefer natural approaches, those with medical reasons they can’t take prescription medications, and women concerned about hormone therapy risks should pay attention to this research. However, women with severe symptoms, those with certain health conditions like breast cancer, or those taking multiple medications should work closely with their doctor before trying supplements. Men and people not going through menopause won’t find this directly applicable.

Lifestyle changes like exercise typically show benefits within 4-8 weeks, though some improvements may take longer. Over-the-counter supplements usually take 4-12 weeks to show effects, and some may take even longer. Behavioral therapy often shows improvements within 6-8 weeks of starting. It’s important to give these approaches time to work and to be patient with yourself. If you haven’t seen improvement after 8-12 weeks, talk to your doctor about next steps.

Want to Apply This Research?

  • Track daily menopause symptoms (hot flashes, night sweats, mood changes, sleep quality) on a scale of 1-10, along with exercise minutes completed and meals eaten. This creates a clear picture of how lifestyle changes affect your symptoms over time.
  • Set a specific, achievable goal like ‘walk 30 minutes, 4 days per week’ or ’eat vegetables at lunch and dinner.’ Use the app to log these activities daily and celebrate weekly progress. If trying a supplement, log when you take it and rate your symptoms that day to see if there’s a connection.
  • Review your symptom patterns weekly to see if exercise, diet, or supplements are helping. Create a monthly summary to share with your doctor. If symptoms aren’t improving after 8-12 weeks, use the app data to discuss next options with your healthcare provider. Track any side effects or concerns with supplements to discuss with your doctor.

This research summary is for educational purposes only and should not replace professional medical advice. Always consult with your healthcare provider before starting any new supplements, especially if you take other medications, have a history of breast cancer, or have other health conditions. Some over-the-counter products can interact with medications or may not be safe for certain medical conditions. While lifestyle changes and behavioral therapy are generally safe, individual results vary. Your doctor can help you determine which approaches are right for your specific situation and health history.