Menopause Without HRT: 5 interventions to explore.

For many women, Hormone Replacement Therapy (HRT) can be life-changing during menopause. But for others, it’s not the right fit—whether due to health conditions, personal preference, or risk factors. Fortunately, there is a growing body of evidence supporting natural, integrative approaches that can offer relief from common symptoms.

Which is why MPOWDER, a UK-based brand known for its award-winning menopause formulations and community-led research initiatives, is such a valuable addition to the work we do here - because it supports a holistic approach to midlife wellness. Below are five well-researched alternatives to HRT—some of which are used in MPOWDER's formulations—to support women through the menopause transition.

1. Cognitive Behavioral Therapy (CBT) CBT was originally developed to treat anxiety and depression, but it’s now widely recognized for its effectiveness in addressing menopause-related issues—particularly vasomotor symptoms (like hot flashes), mood swings, and sleep disturbances.

A 2019 review in BJOG confirmed that CBT significantly improves wellbeing and reduces the distress caused by hot flashes and night sweats. While CBT doesn’t alter hormone levels, it helps reframe the body's response to symptoms, reducing their impact.

How to try it: Search for a licensed therapist with expertise in midlife or women’s health, or explore digital CBT programs tailored to menopause support.

2. Acupuncture An ancient practice in Traditional Chinese Medicine, acupuncture is gaining clinical validation for menopause symptom management—particularly hot flashes, mood balance, and sleep.

A 2023 meta-analysis in BMJ Open found that acupuncture significantly reduced the frequency and intensity of hot flashes and improved anxiety and sleep quality in perimenopausal and postmenopausal women.

How to try it: Visit a licensed acupuncturist with a background in reproductive or menopause health.

3. Ashwagandha (Withania somnifera) Ashwagandha is an adaptogenic herb used to modulate the stress response and support hormone balance. Elevated cortisol levels can intensify menopause symptoms such as insomnia, anxiety, fatigue, and weight gain. Ashwagandha helps regulate these patterns.

A 2021 randomized clinical trial found Ashwagandha significantly improved sleep, reduced hot flashes, and enhanced mood in perimenopausal women.] MPOWDER includes KSM-66 Ashwagandha in its Mood Food and Meno-Boost blends.

Note: Always consult your provider before adding Ashwagandha, especially if you have thyroid conditions or are on medication.

4. Gut Health and Prebiotics Hormonal shifts in menopause affect the gut microbiome, which plays a key role in inflammation, immunity, and estrogen metabolism.

Prebiotics—fibers that feed beneficial gut bacteria—can restore microbial balance and improve the body’s ability to process phytoestrogens from food. A 2020 study in Nutrients found that prebiotic support improved gut barrier integrity and lowered inflammation markers in menopause models.

MPOWDER’s Gut Instinct formula includes kiwi powder (ACTAZIN®), slippery elm, and marshmallow root to support digestion and the microbiome.

5. The Mediterranean Diet The Mediterranean diet has been extensively studied for its cardiovascular and metabolic benefits. It’s particularly effective in midlife due to its anti-inflammatory properties and nutrient density.

A 2022 review in Frontiers in Nutrition linked adherence to the Mediterranean diet with reduced vasomotor symptoms, better mood, and improved heart health during menopause.

How to try it: Focus on diverse plant foods, legumes, leafy greens, extra virgin olive oil, whole grains, and omega-rich seafood.

Final Thoughts For those unable or unwilling to pursue HRT, menopause support doesn't stop there. Through a combination of clinical therapies, nutrition, and natural compounds, many women find relief. Brands like MPOWDER are leading the charge in integrative menopause care—bridging traditional wisdom with modern science and tracking results through real-world community insight. And we’re here to support you, every step of the way too.

Note: Always consult a licensed healthcare provider before starting new supplements or therapies, particularly if you are managing a medical condition