Complementary Therapies for Hot Flushes: What Works and What Doesn’t?
- WA Menopause Clinic
- Jun 13
- 2 min read
At WA Menopause Clinic, we know that hot flushes and night sweats can be distressing, exhausting, and disruptive to everyday life. While menopausal hormone therapy (MHT) remains the most effective treatment, many women in Perth ask us about “natural” or complementary therapies to relieve these symptoms—especially if they cannot take hormones due to personal or medical reasons.
So, what does the evidence actually say?
Are Herbal and “Natural” Therapies Safe and Effective?
Complementary and herbal remedies are widely marketed for menopause, often described as “natural” alternatives. These may include black cohosh, red clover, soy isoflavones, flaxseed, or evening primrose oil. However, despite their popularity, the scientific evidence is mixed, and safety can be a concern.
Black cohosh (isopropanolic extract) may improve symptoms short-term, but long-term safety data are limited.
Red clover and soy isoflavones contain phytoestrogens that mimic weak oestrogen activity. Some studies suggest benefit, especially for women who can metabolise soy into equol—a trait more common in Asian populations.
St John’s wort, often used for mood symptoms, may help when combined with black cohosh, but it can interfere with prescription medications.
Evening primrose oil, flaxseed, and ashwagandha have limited and inconsistent results. Ashwagandha, in particular, has been linked to liver injury in recent TGA safety alerts.
Importantly, herbal remedies are not subject to the same rigorous testing as prescription medications, and some may contain contaminants or interact with other drugs.
What About Bioidentical Hormones?
Compounded bioidentical hormone therapies are not recommended. Despite being marketed as “safer” or “more natural,” they lack standardisation, clinical evidence, and regulatory oversight. Leading medical societies, including the Australasian Menopause Society, caution against their use due to concerns about safety, potency, and efficacy. At WA Menopause clinic, we focus on "Body-identical hormones" which have been TGA tested and verified.
Are There Safe Non-Hormonal Options?
Yes. For women who cannot or choose not to take hormones, evidence-based non-hormonal options include:
Prescription medications such as SSRIs, SNRIs, gabapentin, or clonidine
Lifestyle changes, including reducing caffeine, alcohol, and spicy foods
Cognitive behavioural therapy (CBT) and clinical hypnosis
Vitamin E (in small trials) showed minimal benefit in reducing hot flushes
Omega-3 fatty acids may support heart health, though their impact on hot flushes is unclear
These treatments have varying degrees of effectiveness and should be tailored to the individual.
Expert Menopause Advice in Perth
At WA Menopause Clinic, our doctors stay up-to-date with the latest research to give you honest, evidence-based advice. We take time to listen, assess your full health picture, and help you decide what’s safe, effective, and right for you—whether that includes MHT, prescription non-hormonal treatments, or monitored complementary options.
Clinics in Kalamunda and East Fremantle
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