Step 1 · First-line care

What to do first

Lifestyle adjustments such as lighter clothing, a cooler sleep environment, and identifying personal triggers may improve comfort but are not disease-modifying treatments. For troublesome vasomotor symptoms, hormone therapy is the most effective treatment for many eligible patients, and evidence-based nonhormonal options include selected SSRIs/SNRIs, gabapentin, fezolinetant, oxybutynin, cognitive behavioral therapy, and clinical hypnosis. Current Menopause Society guidance does not recommend supplements or herbal remedies for vasomotor symptoms.

Step 2 · Safety

When to get medical help

Ask a clinician

Get medical help if arrange medical assessment if menopause symptoms are significantly affecting you, you develop palpitations, or bleeding becomes unexpectedly heavier during perimenopause.

Ask a clinician

Get medical help if arrange prompt medical assessment for any vaginal bleeding or spotting after 12 months without a period, even if it happens only once.

Extra caution: Treatment choice differs for people with a history of breast or other hormone-sensitive cancer, cardiovascular or thromboembolic risk, liver disease, complex medication use, or surgical/early menopause. Herbal products should not be presented as a substitute for individualized menopause treatment.