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Alternatives to HRT

If you cannot take HRT or decide not to, there are other ways to relieve menopause symptoms.

These include:

  • lifestyle changes
  • other medicines
  • herbal remedies

Lifestyle changes

Changing your lifestyle can help to:

  • reduce hot flushes
  • improve sleep
  • boost your mood
  • keep your bones strong

Some things that can help include:

Wear loose clothes and sleep in a cool, airy room if you have hot flushes and night sweats.

Activities such as meditation, tai chi and yoga may help you relax.

Tips for reducing hot flushes

Things you can do to help menopause symptoms

Vaginal moisturiser

Try vaginal moisturisers or lubricant if you have vaginal dryness.

You can get different types without a prescription at a pharmacy. Ask to talk with a pharmacist in private if you'd like help to decide which moisturiser is right for you.

If you're having sex and using condoms, do not use oil-based lubricant. This can damage condoms. Use a water-based lubricant.

Treatment for vaginal dryness

Other medicines

Your GP may be able to prescribe you other medicines that help with menopause symptoms.

These include medicines that help with:

  • hot flushes and night sweats
  • bladder function
  • sleep problems
  • joint pains

Antidepressants

Your GP may prescribe an antidepressant 'off label' to treat hot flushes caused by menopause.

There are 2 types that can help:

  • selective serotonin reuptake inhibitors (SSRIs), such as citalopram and sertraline
  • serotonin-noradrenaline reuptake inhibitors (SNRIs), such as venlafaxine and duloxetine
What is off label use?

Off-label use is when a medicine is prescribed in a way that is different to how it was first licensed. Your GP may prescribe a medicine off label if they think it will treat your condition effectively.

Off label use does not mean that the medicine is unsafe. Your GP will tell you if they are prescribing the medicine off label. They will only prescribe it if the benefits outweigh any risks.

Talk to your pharmacist or GP if you have any concerns or questions about off-label use.

Side effects of SSRIs and SNRIs

Clonidine

Clonidine is a prescription medicine that can help reduce hot flushes and night sweats caused by menopause. You take it as tablets 2 times a day.

It does not affect hormone levels so, unlike HRT, it can be taken if you have had breast cancer.

Clonidine can also cause side effects such as:

  • dry mouth
  • drowsiness
  • depression
  • constipation

It may take 2 to 4 weeks to notice the effects of clonidine. Talk to your GP if your symptoms do not improve or you have problems with side effects.

Herbal remedies

Several products are sold without prescription or in health shops for treating the symptoms of menopause.

For example, herbal remedies like:

  • evening primrose oil
  • black cohosh
  • red clover
  • angelica
  • ginseng
  • St John's wort

Some of these remedies, including black cohosh and St John's wort, may help reduce hot flushes.

St John's wort may also cause serious side effects if taken with other medicines. Talk to your GP or pharmacist if you intend to take it with other prescribed medicines.

There is very little scientific evidence that herbal remedies work. Even when there is some supporting evidence, there's uncertainty about the right doses to use and if the health benefits last.

Ask your GP or pharmacist for advice if you're thinking about using a herbal remedy.

Page last reviewed: 1 May 2025
Next review due: 1 May 2028