Many women complain about menopause, but there is an upside … eventually. “This natural transition for women has been overmedicalized and stigmatized as a very unpleasant time,” says Erika Siegel, ND, who practices holistic primary care and women’s medicine at the Nature Cures Clinic in Portland, Oregon. “But in some cultures, menopause is a welcomed passage into the honored role of being a wise elder. Women who take really good care of themselves can gracefully transition with relatively little discomfort.”

Few women experience all menopause symptoms, which include hot flashes, low libido, and mood swings, but dealing with just one can be plenty frustrating. Find solutions to your changing needs with these natural, effective herbal remedies and tips.

Hot flashes. Fluctuating estrogen levels can cause hot flashes, which occur suddenly and range in intensity from a mild warming sensation to a drenching nighttime sweat. Two herbs—the Thai herb Pueraria mirifica and black cohosh—stand out for reducing the intensity and frequency of hot flashes. Both herbs are sold in capsule form and can be taken separately or in combination.

Dose:  Approximately 200 mg P. mirifica daily; 200 mg whole-root black cohosh or 20–40 mg standardized extract once or twice daily.

Insomnia. Inability to sleep, one of the most common problems middle-aged women voice, can lead to feeling perpetually tired and boost the risk of type 2 diabetes and heart disease. Siegel suggests a combination of magnesium and phosphorylated serine in the evening. Together, they relax the nervous system and blunt the rise in stress hormones, a common menopause occurrence. “Women also need to wind down at the end of the day, avoiding stimulating exposure to movies, the news, and heated conversations,” she adds.

Dose: 200 mg magnesium citrate and 1,000 mg phosphorylated serine each evening.

Low sex drive. Siegel often recommends maca root to her patients. Cultivated in the Andes, this plant is traditionally used to enhance libido. It works at least in part by balancing hormones across the entire endocrine system. You’ll find it in supplement form and also as a malty-tasting powder you can add to smoothies. Half a teaspoon provides about 1,500 mg of the root.

Dose: 1,000–1,500 mg daily in capsule or powder form.

Vaginal dryness. P. mirifica contains at least 17 different plant estrogens, weak versions of human-produced estrogen. In a study of 71 women, taking supplements of the herb for 24 weeks significantly reduced vaginal dryness. Plain coconut oil applied topically also works well as a lubricant, Siegel says.

Dose: 200 mg P. mirifica twice daily.

Brain fog. Feeling spacey? You might want to get a full blood panel (TSH, T3, T4, rT3) to make sure low thyroid activity, common in middle-aged women, isn’t the underlying cause, Siegel says. She also suggests high-potency B-complex together with ginkgo supplements; both can improve cognition and memory.

Dose: Start with a B-complex containing 25–50 mg each of B1, B2, and B3 daily. In combination, try 120 mg standardized ginkgo per day in divided doses.

Moodiness. In some women, hormonal shifts trigger rapid or long-term mood changes. First, don’t forget to exercise: “It’s the best remedy for mood swings, anxiety, and depression,” says Siegel. For anxiety, try motherwort, a member of the mint family, or lemon balm. For depression, use St. John’s wort.

Dose: Herbal preparations vary, so consult an herbalist or health care provider.

Recommended supplements

Remifemin. Numerous studies show this standardized black cohosh supplement to ease menopause symptoms.

Solgar PM PhytoGen Complex. A source of Pueraria mirifica and several B vitamins.

Wise Woman Herbals Maca Capsules. Contains 520 mg maca root per capsule.