Menopausal Symptoms (Other Than Osteoporosis)

Menopausal Symptoms (Other Than Osteoporosis)

Related Terms

Hot Flashes/Flushes

Menopause is when a woman has not had a period for one year. It is a normal part of aging that happens between the ages of 40 to 58. It can cause hot flashes, problems sleeping, and vaginal dryness.

Hormone replacement therapy and other medicines can be used to manage symptoms. Healthy habits may also help. Natural therapies have been used to ease symptoms as well.

Natural Therapies

Likely Effective

These herbs and supplements are likely to ease symptoms:

  • Black cohosh is an herb that can be taken as a supplement. ( Note : It should not be taken by women who have problems with their immune system.)B2. B5, B7, B10, B38
  • Genistein is found in soybeans, soymilk, and other soy products. It can also be taken as a pill. ( Note : It should not be taken by women who take hormone medicine or people with bone problems.)B6, B21
  • Ginseng is a plant that can be made into a drink or taken as a supplement. ( Note : Ginseng may not be safe when taken for a long time or by women with certain health problems.)B22, B39
  • Isoflavones are compounds found in plants.B6, B15, B16, B27, B30-B32
  • Omega-3 fatty acids are a class of essential fatty acids found in fish oils.B29
  • Red clover is a plant. The flowers can be taken as a supplement or made into a tea. ( Note : It should not be taken with contraception. It may also not be safe to take with blood thinners.)B3, B9. B13, B18, B19, B24
  • St. John's wort is a plant that can be taken as a supplement or made into a tea. ( Note It may not be safe when taken by women with certain health problems.)B11

These therapies are also likely to ease symptoms:

  • Acupuncture is likely to reduce hot flashes, ease symptoms, and improve sleep and quality of life.A1-A5
  • Yoga is likely to ease symptoms.C1-C4

May Be Effective

These therapies may ease symptoms:

  • Flaxseed can be used in cooking or taken as a supplement.B17, B37
  • Hops are small flowers that can be taken as a supplement or made into a tea. ( Note : Hops should not be taken with medicine to treat sleep problems.)B23
  • Lemon balm is an herb that can be taken as a supplement or made into a tea.B8
  • Oligomeric proanthocyanidins (OPCs) are substances found in fruits such as grapes.B12
  • Phytoestrogens are an estrogen found in foods such as legumes.B28, B33, B35, B36
  • Tribulus terrestris is a vine that can be taken as a supplement. ( Note : It may cause stomach cramping and diarrhea.)B20
  • Valerian is a plant. The root can be taken as an extract or made into a tea. ( Note : It should not be taken by women who take medicine for diarrhea, pain, anxiety, or problems sleeping.)B4, B8, B25

Editorial process and description of evidence categories can be found at EBSCO NAT Editorial Process.

Herbs and Supplements to Be Used With Caution

Talk to your doctor about any supplements or therapy you would like to use. Some can interfere with treatment or make conditions worse, such as:

  • Black cohosh may make the immune system more active. Talk to your doctor before taking it if you have problems with your immune system.
  • Genistein may interact with hormone medicine and medicine for bone problems. Talk to your doctor before taking it.
  • Ginseng may not be safe when taken for a long time or by women with certain health problems, such as auto-immune diseases or bleeding problems.
  • Hops should not be taken with medicine to treat problems sleeping. It may cause a bad reaction.
  • Red clover may block the effectiveness of contraception. It should also not be taken by women who are taking blood thinners.
  • St. John’s wort may not be safe when taken by people with certain health problems, such as HIV or heart problems.
  • Tribulus terrestris may cause stomach cramping and diarrhea.
  • Valerian may react with medicine used to treat diarrhea, pain, anxiety, or sleep problems. Talk to your doctor before taking it.



A1. Chiu HY, Pan CH, et al. Effects of acupuncture on menopause-related symptoms and quality of life in women in natural menopause: a meta-analysis of randomized controlled trials. Menopause. 2015;22(2):234-244.

A2. Chiu HY, Hsieh YJ, et al. Acupuncture to Reduce Sleep Disturbances in Perimenopausal and Postmenopausal Women: A Systematic Review and Meta-analysis. Obstet Gynecol. 2016 Mar;127(3):507-515.

A3. Befus D, Coeytaux RR, et al. Management of Menopause Symptoms with Acupuncture: An Umbrella Systematic Review and Meta-Analysis. J Altern Complement Med. 2018 Apr;24(4):314-323.

A4. Li W, Luo Y, et al. Acupuncture May Improve Quality of Life in Menopausal Women: A Meta-Analysis of Randomized Controlled Trials. Complement Med Res. 2018;25(3):183-190.

A5. Dodin S, Blanchet C, et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst Rev. 2013 Jul 30;(7):CD007410.

Herbs and Supplements

B1. Nedrow A, Miller J, et al. Complementary and alternative therapies for the management of menopause-related symptoms: a systematic evidence review. Arch Intern Med. 2006;166(14):1453-1465.

B2. Shams T, Setia MS, et al. Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis. Altern Ther Health Med. 2010;16(1):36-44.

B3. Lipovac M, Chedraui P, et al. Improvement of postmenopausal depressive and anxiety symptoms after treatment with isoflavones derived from red clover extracts. Maturitas. 2010;65(3):258-261.

B4. Taavoni S, Ekbatani N, et al. Effect of valerian on sleep quality in postmenopausal women: a randomized placebo-controlled clinical trial. Menopause. 2011; 18(9): 951-955.

B5. Ross SM. Menopause: a standardized isopropanolic black cohosh extract (remifemin) is found to be safe and effective for menopausal symptoms. Holist Nurs Pract. 2012;26(1):58-61.

B6. Taku K, Melby MK, et al. Extracted or synthesized soybean isoflavones reduce menopausal hot flash frequency and severity: systematic review and meta-analysis of randomized controlled trials. Menopause. 2012;19(7):776-790.

B7. Schellenberg R, Saller R, et al. Dose-Dependent Effects of the Cimicifuga racemosa Extract Ze 450 in the Treatment of Climacteric Complaints: A Randomized, Placebo-Controlled Study. Evid Based Complement Alternat Med. 2012;2012:260301.

B8. Taavoni S, Nazem Ekbatani N, et al. Valerian/lemon balm use for sleep disorders during menopause. Complement Ther Clin Pract. 2013;19(4):193-196.

B9. Mainini G, Torella M, et al. Nonhormonal management of postmenopausal women: effects of a red clover based isoflavones supplementation on climacteric syndrome and cardiovascular risk serum profile. Clin Exp Obstet Gynecol. 2013;40(3):337-341.

B10. Zheng TP, Sun AJ, et al. Efficacy and safety on Cimicifuga foetida extract on menopausal syndrome in Chinese women. Chin Med J. 2013;126(11):2034-2038.

B11. Liu YR, Jiang YL, et al. Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety. Climacteric. 2014;17(4):325-335.

B12. Terauchi M, Horiguchi N, et al. Effects of grape seed proanthocyanidin extract on menopausal symptoms, body composition, and cardiovascular parameters in middles-aged women: a randomized, double-blind, placebo-controlled pilot study. Menopause. 2014;21(9):990-996.

B13. Gartoulla P, Han MM. Red clover extracts for alleviating hot flushes in postmenopausal women: a meta-analysis. Maturitas. 2014;79(1):58-64.

B14. Scheffers CS, Armstrong S, et al. Dehydroepiandrosterone for women in the peri- or postmenopausal phase. Cochrane Database Syst Rev. 2015;1:CD011066.

B15. Cheng PF, Chen JJ, et al. Do soy isoflavones improve cognitive function in postmenopausal women? A meta-analysis. Menopause. 2015;22(2):198-206.

B16. Li L, Lv Y, et al. Quantitative efficacy of soy isoflavones on menopausal hot flashes. Br J Pharmacol. 2015;79(4):593-604.

B17. Cetisli NE, Saruhan A, et al. The effects of flaxseed on menopausal symptoms and quality of life. Holist Nurs Pract. 2015;29(3):151-157.

B18. Shakeri F, Taavoni S, et al. Effectiveness of red clover in alleviating menopausal symptoms: a 12-week randomized, controlled trial. Climacteric. 2015;18(4):568-573.

B19. Ghazanfarpour M, Sadeghi R, et al. Red clover for treatment of hot flashes and menopausal symptoms: A systematic review and meta-analysis. J Obstet Gynaecol. 2016;36(3):301-311.

B20. Postigo S, Lima SM, et al. Assessment of the Effects of Tribulus Terrestris on Sexual Function of Menopausal Women. Rev Bras Ginecol Obstet. 2016;38(3):140-146.

B21. Fang K, Dong H, et al. Soy isoflavones and glucose metabolism in menopausal women: A systematic review and meta-analysis of randomized controlled trials. Mol Nutr Food Res. 2016;60(7):1602-1614.

B22. Lee HW, Choi J, et al. Ginseng for managing menopausal woman’s health: A systematic review of double-blind, randomized, placebo-controlled trials. Medicine (Baltimore). 2016;95(38):e4914.

B23. Aghamiri V, Mirghafourvand M, et al. The effect of Hop (Humulus lupulus L.) on early menopausal symptoms and hot flashes: A randomized placebo-controlled trial. Complement Ther Clin Pract. 2016;23:130-135.

B24. Myers SP, Vigar V. Effects of a standardized extract of Trifolium pretense (Promensil) at a dosage of 80mg in the treatment of menopausal hot flushes: A systematic review and meta-analysis. Phytomedicine. 2017;24:141-147.

B25. Jenabi E, Shobeiri F, et al. The effect of Valerian on the severity and frequency of hot flashes: A triple-blind randomized clinical trial. Women Health. 2018;58(3):297-304.

B26. Xiong X, Yang X, et al. Efficacy and safety of Chinese herbal medicine for patients with postmenopausal hypertension: A systematic review and meta-analysis. Pharmacol Res. 2019 Mar;141:481-500.

B27. Daily JW, Ko BS, et al. Equol Decreases Hot Flashes in Postmenopausal Women: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food. 2019 Feb;22(2):127-139.

B28. Najaf Najafi M, Ghazanfarpour M. Effect of phytoestrogens on sexual function in menopausal women: a systematic review and meta-analysis. Climacteric. 2018 Oct;21(5):437-445.

B29. Mohammady M, Janani L, et al. Effect of omega-3 supplements on vasomotor symptoms in menopausal women: A systematic review and meta-analysis. Eur J Obstet Gynecol Reprod Biol. 2018 Sep;228:295-302.

B30. Li L, Xu L, et al. Comparative efficacy of nonhormonal drugs on menopausal hot flashes. Eur J Clin Pharmacol. 2016 Sep;72(9):1051-1058.

B31. Ghazanfarpour M, Sadeghi R, et al. The application of soy isoflavones for subjective symptoms and objective signs of vaginal atrophy in menopause: A systematic review of randomised controlled trials. J Obstet Gynaecol. 2016;36(2):160-171.

B32. Thomas AJ, Ismail R, et al. Effects of isoflavones and amino acid therapies for hot flashes and co-occurring symptoms during the menopausal transition and early postmenopause: a systematic review. Maturitas. 2014 Aug;78(4):263-276.

B33. Franco OH, Chowdhury R, et al. Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis. JAMA. 2016 Jun 21;315(23):2554-2563.

B34. Zhu X, Liew Y, et al. Chinese herbal medicine for menopausal symptoms. Cochrane Database Syst Rev. 2016 Mar 15;3:CD009023.

B35. Chen MN, Lin CC, et al. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric. 2015 Apr;18(2):260-269.

B36. Lethaby A, Marjoribanks J, et al. Phytoestrogens for menopausal vasomotor symptoms. Cochrane Database Syst Rev. 2013 Dec 10;(12):CD001395.

B37. Dew TP, Williamson G. Controlled flax interventions for the improvement of menopausal symptoms and postmenopausal bone health: a systematic review. Menopause. 2013 Nov;20(11):1207-1215.

B38. Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012 Sep 12;(9):CD007244.

B39. Shergis JL, Zhang AL, et al. Panax ginseng in randomised controlled trials: a systematic review. Phytother Res. 2013 Jul;27(7):949-965.

B40. Lee MS, Shin BC, et al. Maca (Lepidium meyenii) for treatment of menopausal symptoms: A systematic review. Maturitas. 2011 Nov;70(3):227-233.


C1. Jorge MP, Santaella DF, et al. Hatha Yoga practice decrease menopause symptoms and improves quality of life: A randomized controlled trial. Complement Ther Med. 2016;26:128-135.

C2. Cramer H, Peng W, et al. Yoga for menopausal symptoms-A systematic review and meta-analysis. Maturitas. 2018 Mar;109:13-25.

C3. Shepherd-Banigan M, Goldstein KM, et al. Improving vasomotor symptoms; psychological symptoms; and health-related quality of life in peri- or post-menopausal women through yoga: An umbrella systematic review and meta-analysis. Complement Ther Med. 2017 Oct;34:156-164.

C4. Innes KE, Selfe TK, et al. Mind-body therapies for menopausal symptoms: a systematic review. Maturitas. 2010 Jun;66(2):135-149.

Relaxation Therapies

D1. Saensak S, Vutyavanich T, et al. Relaxation for perimenopausal and postmenopausal symptoms. Cochrane Database Syst Rev. 2014 Jul 20;(7):CD008582.

D2. Goldstein KM, Shepherd-Banigan M, et al. Use of mindfulness, meditation and relaxation to treat vasomotor symptoms. Climacteric. 2017 Apr;20(2):178-182.


E1. Daley A, Stokes-Lampard H, et al. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2014 Nov 28;(11):CD006108.

Last reviewed October 2019 by EBSCO NAT Review Board Eric Hurwitz, DC
Last Updated: 6/8/2020

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