As a woman approaches menopause, the multitude of symptoms and the uncertainty of treatment options can be overwhelming. The list of possible symptoms is abundant: hot flashes, night sweats, sleep disturbances, mood and emotional lability, forgetfulness, difficulty concentrating, brain fog, vaginal dryness and burning, pain with intercourse, decreased libido, urinary frequency, urinary tract infections, dry skin, thinning hair, risk of osteopenia or osteoporosis, and changes in cardiovascular risk factors, all of which can be difficult to understand, diagnose, navigate, manage, and treat. Although Menopause is a natural biological stage of transition, women do not need to tolerate or even suffer through the symptoms that interfere with their quality of life. A variety of Integrative and Complementary treatment options exist which can be comforting and reassuring to women due to the vast array of symptoms and the differing severity that one may experience throughout their menopause journey.
Acupuncture
Although systematic reviews and clinical trials have produced inconsistent results on acupuncture for menopause symptoms, some studies report reductions in hot flashes and night sweats compared with no treatment, and others show improvements in sleep and quality of life.
The following article is a pragmatic, randomized controlled trial of 209 perimenopausal and postmenopausal women aged 45 to 60 years. Researchers found that acupuncture treatments were associated with a significant reduction in hot flashes and night sweats compared with no acupuncture, and that clinical benefit persisted for at least 6 months after treatment ended. Statistically significant clinical improvement was observed after three acupuncture treatments, and maximal clinical effects occurred after a median of eight treatments.
Acupuncture in Menopause (AIM) Study: a Pragmatic, Randomized Controlled Trial - PMC
Naturopathy and Nutritional Counseling
Symptoms of menopause occur because the ovaries gradually produce less estrogen and progesterone, causing hormonal fluctuations that lead to a multitude of symptoms of varying degrees. Estrogen and progesterone not only regulate menstrual periods, but they also affect the brain, body temperature, sleep, mood, bones, muscles, urinary tract, and vaginal tissues. As hormone levels fluctuate and eventually decline, the body must adapt to functioning with less of this specific hormonal support. This explains why some treatment options for menopause symptoms mimic the actions of estrogen and/or progesterone. Although current study results are mixed and more research is needed to make specific recommendations, some women have found benefit from the following complementary treatments.
Soy
Soy isoflavones are phytoestrogens that are known to have estrogen-like and antioxidant-inhibiting inflammatory effects. Therefore, soy isoflavones are thought to be effective in treating menopausal symptoms.
The following systematic review and analysis of 62 studies involving 6,653 women found that specific phytoestrogen supplementations, such as soy isoflavones, were associated with modest reductions in the frequency of hot flashes and vaginal dryness.
Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis - PubMed
Additionally, soy isoflavones may benefit bone density in postmenopausal women. A systematic review and meta-analysis of 18 randomized controlled trials suggests that soy isoflavones effectively decrease bone loss after menopause.
Red Clover
Red clover isoflavones are also phytoestrogens that are thought to mimic some estrogen activity by binding to estrogen receptors and potentially producing weak estrogen-like effects. Although the clinical evidence is inconsistent, the following abstract showed that “red clover consumption may decrease frequency of hot flashes, especially in women with severe hot flashes (≥ 5 per day).”
The following meta-analysis of 8 trials showed a statistically significant reduction in the daily incidence of hot flushes in women receiving red clover compared with placebo.
Black Cohosh
The exact mechanism of black cohosh is not well established, but it is thought that black cohosh may influence serotonin-related pathways involved in temperature regulation and the body’s response to hot flashes, as well as possible anti-inflammatory and antioxidant activity. Although the following abstract of 47 randomized controlled trials for vasomotor symptoms (hot flashes and night sweats) during menopause concluded that treatment with transdermal estrogen and progestogen was most efficacious, the results also showed that treatment with isoflavone and black cohosh were more effective for treating hot flashes and night sweats than placebo.
Acupuncture, naturopathy, and nutritional counseling may offer supportive options for managing menopause symptoms. Although clinical results vary and evidence for their effectiveness is mixed, every woman’s menopausal experience is unique and may benefit from a trial of integrative treatment depending on symptom burden, lifestyle impact, timing, and overall health. An integrative approach that combines evidence-based medical care with carefully selected complementary therapies may help some women improve symptom management and quality of life. Working with qualified healthcare professionals is essential to monitor tolerance and side effects and to prevent medication interactions when tailoring treatment to individual needs, preferences, and responses to therapy.
References:
1. Avis, Nancy E et al. “Acupuncture in Menopause (AIM) study: a pragmatic, randomized controlled trial.” Menopause (New York, N.Y.)vol. 23,6 (2016): 626-37. doi:10.1097/GME.0000000000000597
2. Franco, Oscar H et al. “Use of Plant-Based Therapies and Menopausal Symptoms: A Systematic Review and Meta-analysis.” JAMA vol. 315,23 (2016): 2554-63. doi:10.1001/jama.2016.8012
3. Luan, Haodi et al. “Effects of soy isoflavones on menopausal symptoms in perimenopausal women: a systematic review and meta-analysis.” PeerJ vol. 13 e19715. 23 Jul. 2025, doi:10.7717/peerj.19715
4. Barańska, Agnieszka et al. “The Role of Soy Isoflavones in the Prevention of Bone Loss in Postmenopausal Women: A Systematic Review with Meta-Analysis of Randomized Controlled Trials.” Journal of Clinical Medicine vol. 11,16 4676. 10 Aug. 2022, doi:10.3390/jcm11164676
5. Ghazanfarpour, M et al. “Red clover for treatment of hot flashes and menopausal symptoms: A systematic review and meta-analysis.” Journal of Obstetrics and Gynecology: The Journal of the Institute of Obstetrics and Gynecology vol. 36,3 (2016): 301-11. doi:10.3109/01443615.2015.1049249
6. Kanadys, Wiesław et al. “Evaluation of Clinical Meaningfulness of Red Clover (Trifolium pratense L.) Extract to Relieve Hot Flushes and Menopausal Symptoms in Peri- and Post-Menopausal Women: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” Nutrients vol. 13,4 1258. 11 Apr. 2021, doi:10.3390/nu13041258
7. Sarri, G et al. “Vasomotor symptoms resulting from natural menopause: a systematic review and network meta-analysis of treatment effects from the National Institute for Health and Care Excellence guideline on menopause.” BJOG: an international journal of obstetrics and gynecology vol. 124,10 (2017): 1514-1523. doi:10.1111/1471-0528.14619
