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Take the AssessmentPerimenopause Symptom Summary
Significant symptoms
Selected as having a major impact on daily life
Your symptoms
As reported in your assessment
Mild symptoms
Present but lower impact
Pattern by category
Number of symptoms reported in each area
Your treatment options, explained
What's FDA-approved, what the evidence supports, and what's hype
Backed by strong evidence (some FDA-approved)
- Hormone therapy: for example, transdermal estradiol (patch or gel) with micronized progesterone. FDA-approved for moderate to severe hot flashes and night sweats, and first-line for those symptoms per The Menopause Society's 2022 position statement. It isn't right for everyone. In late 2025 the FDA began removing some boxed warnings from these labels, but the labels still list risks and reasons not to use it, such as a history of breast cancer, blood clots, stroke, heart attack, or unexplained vaginal bleeding. Women with a uterus need a progestogen like progesterone to protect the uterine lining, and risks rise with age at starting.
- Fezolinetant (Veozah): an FDA-approved non-hormonal option for moderate to severe hot flashes and night sweats, for women who can't take or don't want hormones. It carries an FDA boxed warning for serious liver injury, so it requires liver blood tests before starting and at set points over the first 9 months. Signs of liver problems, like yellowing skin or eyes or dark urine, mean stopping it and seeking care.
- Low-dose vaginal estrogen: an FDA-approved, standard treatment for vaginal dryness and discomfort. It works mostly locally, but it isn't risk-free, and anyone with a history of breast cancer should discuss it with their oncology team.
- CBT-I and non-hormonal prescriptions: CBT-I (a structured sleep therapy) is the first-line treatment for chronic insomnia. For some women, non-hormonal prescriptions can also help with hot flashes, sleep, or mood. Most are used off-label, and each has side effects to weigh with a clinician.
Mostly hype. Spend carefully
- Compounded "bioidentical" pellets: unregulated dosing, not FDA-approved, and specifically cautioned against by The Menopause Society.
- Hormone-"balancing" test panels: perimenopause is a clinical diagnosis based on age, cycle changes, and symptom pattern; single-day hormone levels swing too much to be diagnostic.
- Untested supplement stacks: a handful of supplements have modest evidence for specific symptoms; "hormone support" blends generally don't.
Which of these fits you depends on your symptoms, history, and preferences, which is exactly what a clinician trained in perimenopause walks you through. That's the care we're building.
This summary is an educational self-assessment, not a medical diagnosis. It is intended to support, not replace, consultation with a qualified healthcare provider. Generated from answers stored privately on this device.
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