HRT, Botanicals, Supplements or White-Knuckle It 'Naturally'?

April 10, 2026|Tania Mullan

YOUR SUPPORT OPTIONS

HRT, Botanicals, Supplements or White-Knuckle It 'Naturally'?

How to build your perimenopause toolkit beneath all the noise.

Written and edited by Tarnia Mullan, Founder of SOMA Wellness Co. · April 2026 · 15 min read

Quick Answer: What are my options for perimenopause and menopause?

You do not have to pick one approach and reject all the others. Your toolkit may include MHT/HRT, non-hormonal medicines, nutrition, strength training, targeted supplements, clinically researched botanicals, therapy, pelvic-floor care, nervous-system practices, community support, or a combination.

The useful question is not "medical or natural?" It is: what job am I trying to do, what evidence supports this option, what are its limits, and does it suit my body, health history and medications?

White-knuckling is not a strategy. Buying everything social media serves you is not one either.

You start with one innocent search. Is HRT safe?

Twenty minutes later you have twelve tabs open, three doctors disagreeing with one another, a woman on Instagram insisting you need creatine before breakfast, a celebrity holding a red-light mask, an ad for a hormone patch that is not actually a hormone patch, and somebody rubbing a stone across her jawline with the urgency of a medical procedure.

Your phone now believes menopause is your entire personality. It follows you from Facebook to the weather app with powders, probiotics, collagen, protein, magnesium, wild-yam cream, facial tools, weighted vests and a supplement stack that appears to require its own pantry and financial adviser.

Meanwhile, your body is not running a debate panel. It is trying to get through the day without snapping, sweating, losing the word for 'bread' or waking at 3:14 a.m. to replay a conversation from last Thursday.

This article is for the woman in the middle of that noise, afraid that choosing the wrong thing could make matters worse, and equally afraid that doing nothing means falling apart.

Menopause has become a market

Women's midlife health is finally visible. That is progress. It also means menopausal women have become an extremely profitable audience.

The problem is not that everything being sold is nonsense. Some of it is grounded in good science. Some of it is promising but early. Some of it may help a particular woman for a particular reason. And some of it is a beautiful container wrapped around a claim the evidence has not earned.

When you are exhausted, frightened about your brain, uncomfortable in your body and desperate to feel like yourself again, certainty is seductive. A confident reel can feel easier to trust than a cautious clinician who says, "It depends."

But "it depends" is often the most honest sentence in women's health.

"The answer is not to become cynical about everything. It is to become educated enough that your hope does not get hijacked." — SOMA Wellness Co.

Different tools have different jobs

Think of your midlife toolkit like renovating a house.

You would not ask the electrician to fix the leaking roof. You would not sack the plumber because the paint colour still feels wrong. And you would not expect one very expensive cushion to repair the broken lounge.

MHT, botanicals, protein, therapy, creatine, sleep, pelvic-floor care and strength training are not rival belief systems. They are different tools for different jobs.

Tool	What it may help with	What it cannot promise
HRT / Hormone Replacement Therapy (oestrogen patches or gel, progesterone, local vaginal oestrogen and, in selected cases, testosterone)	Hot flushes, night sweats, vaginal and urinary symptoms, sleep disrupted by symptoms, and bone protection for appropriate women.	Not one-size-fits-all. Benefits and risks depend on your age, timing, symptoms, medical history, formulation and route.
Non-hormonal prescriptions (some antidepressants used for hot flushes or mood, migraine medicines, prescription sleep support, other symptom-specific medicines)	A defined problem such as hot flushes, low mood, anxiety, migraine or short-term sleep difficulty, depending on the medicine.	Still medicines. Side effects, interactions and the exact symptoms being treated matter. Treats symptoms; doesn't necessarily target underlying causes.
Targeted supplements (vitamin D, vitamin K2, magnesium, iron, B12, folate, omega-3, creatine or protein powder)	Correcting a measured deficiency or supporting a specific need such as bone health, muscle, protein intake or exercise performance.	More is not better. Testing, dose, form, food intake, medicines and health history matter. A supplement should have a job, not simply a convincing label.
Clinically researched botanicals (lemon balm, tulsi, passionflower, chamomile and gotu kola, as infusions or other preparations)	Support for a particular system or symptom — stress load, calm, sleep or cognitive steadiness — depending on the botanical, preparation, amount and evidence.	Natural does not mean weak or risk-free. Quality, meaningful amounts, formulation and interactions matter. A well-crafted infusion is not the same as a token sprinkle in a generic tea bag.
Nutrition and movement (a nutrient-dense diet, enough protein, walking, resistance or strength training)	Muscle, bone, metabolic health, energy, strength, mobility and long-term function.	Foundational does not mean magical. Food and movement cannot replace medical care when a symptom or condition needs assessment or treatment.
Nervous-system practices (breathing, humming, meditation, sound, nature, creativity, gentle movement)	Lowering accumulated stress load and giving the body repeated chances to move from constant demand towards rest, digestion and restoration.	They do not correct iron deficiency, replace bone protection or make a medical condition disappear. Their job is regulation, not pretending biology is all in your head.
Community and therapy (a psychologist, counsellor, support group or women's circle)	Perspective, coping, identity, grief, relationships, shame reduction and feeling less alone.	Fit matters. Not every practitioner, therapy style or group will suit every woman.

MHT/HRT: legitimate medicine, not compulsory membership

In Australia, the preferred term is menopausal hormone therapy, or MHT. Many women still say HRT. Same broad conversation.

MHT is the most effective treatment for hot flushes and night sweats and is a legitimate, evidence-based option for many women. For many healthy, symptomatic women younger than 60 or within 10 years of menopause onset, and without contraindications, major menopause guidance describes a generally favourable benefit-risk balance.

That sentence is not permission to prescribe through a blog. It is permission to stop treating hormones as either poison or salvation.

MHT is not one product. Oestrogen-only therapy, combined oestrogen and progestogen, patches, gels, tablets, local vaginal oestrogen, micronised progesterone and testosterone have different purposes and risk profiles. If you still have a uterus, systemic oestrogen usually needs endometrial protection with progesterone or a progestogen.

Professor Susan Davis, an Australian endocrinologist and one of the world's leading women's-health researchers, has repeatedly argued for individualised, evidence-based menopause care. That is the useful authority position here: not "everyone needs hormones", and not "hormones are dangerous", but the right treatment for the right woman after a proper conversation.

Ask your clinician — a better MHT conversation: Which symptoms are we trying to treat? What are my personal benefits, risks and contraindications? Would the route of delivery change my risk profile? What should we review, and when? What non-hormonal options are available if I cannot or do not want to use MHT?

Supplements: useful tools, expensive panic pantry

Protein powder is food support. Creatine is a well-studied sports supplement. Iron can be essential when you are deficient and harmful when you are not. Magnesium is not one single substance wearing different labels for decoration. These things do not belong in one giant category called 'wellness'.

Protein matters because muscle is a health asset in midlife, not an aesthetic side project. In real life, "eat more protein" may mean eggs at breakfast, Greek yoghurt, tofu, fish, legumes, chicken, cottage cheese or a shake when actual food is not practical. It does not mean you failed because your breakfast did not arrive in a beige influencer bowl.

Creatine deserves a calmer conversation than social media gives it. The strongest evidence remains around strength and exercise performance. Recent research in postmenopausal women suggests improvements in lean mass and strength, especially when creatine is combined with resistance training. Cognitive and mood research is also promising.

Associate Professor Abbie Smith-Ryan's work has helped bring female-specific creatine research into the mainstream. Her useful message is not that every menopausal woman must take creatine. It is that women deserve to be included in the research before the market races ahead of the data.

"Test, do not guess" remains one of the least glamorous and most useful rules. Iron, B12, folate, vitamin D, thyroid function and metabolic markers may be relevant depending on your symptoms and history. The point is not to order every test available. It is to obtain a baseline of what stores of key nutrients are sufficient in your body, and what are not. This then guides the supplement plan so you do not end up with nothing more than expensive urine, or worse, causing damage to organs from over-supplementing.

Botanicals: not woo-woo

Botanicals deserve more respect than both sides usually give them.

They are not the soft, silly woo-woo cousin of medicine. Plants contain active compounds. Some have randomised human trials. Some have traditional-use evidence. Some have early or inconsistent evidence. Some are marketed at doses that bear little resemblance to the research.

The right question is not "Do herbs work?" That is like asking whether medicine works. Which botanical? Which preparation — infusion, powder, tincture or extract? How much? For which outcome? In which woman?

Hormone-active botanicals such as black cohosh, red clover, soy isoflavones, chaste tree and other menopause formulas may suit some women and not others. Cancer history, liver health, thyroid conditions, autoimmune disease, pregnancy potential and medication interactions can all change the conversation.

Another lane focuses less on hormone pathways and more on systems disrupted in midlife: stress load, sleep, cognitive steadiness and the ability to downshift. Lemon balm, passionflower, chamomile, tulsi and gotu kola all have research or longstanding traditional use relevant to parts of that picture. None is a treatment for menopause. None should be marketed as magic. But neither should clinically researched botanicals be dismissed, because they arrive in a cup rather than a blister pack.

Lemon balm is one example. Human trials and a 2021 systematic review found improvements in measures of calm, anxiety and depressive symptoms, with no serious adverse effects reported in the included trials. Tulsi is another, with recent clinical trials highlighting benefits for stress and cognition. And passionflower for sleep onset and depth of sleep. #notwoowoo

"Botanical support is not the consolation prize for women who cannot or do not want to use hormones. It is one legitimate layer in a wider toolkit, when it is chosen carefully and used safely." — SOMA Wellness Co.

Where SOMA sits, and where it deliberately does not

SOMA was not created to compete with MHT, replace prescribed medicine or "balance hormones". It was created because many women needed a trustworthy, high-quality option in another lane: nervous-system support, calmer daytime focus and a more intentional evening downshift.

The SOMA Duo sits in the nervous-system and daily-rhythm layer: Vitalitea Daylight as a morning botanical ritual for calm focus and steadier capacity; Serenitea Moonlight as an evening botanical ritual for settling and supporting rest. These are not token-dusted supermarket teas. The blends use generous proportions of their core botanicals and were intentionally formulated for function as well as flavour.

The formulas were intentionally crafted without phytoestrogenic menopause herbs such as red clover, black cohosh and shatavari, and without ashwagandha or St John's wort. Not because those ingredients are wrong, but because women with medication, autoimmune and hormone-sensitive considerations deserve inclusive, thoughtfully formulated options.

Practices are part of the toolkit too

The menopause market tends to focus on what you can swallow, inject, stick on your arm or add to cart. But bodies also respond to light, movement, breathing, safety, connection, pleasure, rest and repetition.

Strength training helps muscle and bone. Morning light supports circadian timing. Therapy can help with anxiety, grief, identity and relationships. Pelvic-floor physiotherapy can address problems no multivitamin will touch. Breathwork, sound, gentle movement, creativity, time in nature and women's circles can create real periods of nervous-system reprieve.

These practices are not proof that symptoms are all in your head. They acknowledge that physiology is influenced by what you repeatedly experience, not only by what you ingest.

It sounds like another thing to add to the list until you understand the job: not self-improvement, but interruption. Ten minutes when your body is not answering, producing, caring, rushing or bracing.

SOMA Circle — support does not always come in a bottle: SOMA Circle is a monthly gathering for women in North Brisbane to step out of constant demand through botanical ritual, breath, sound, gentle movement, creativity and conversation. It is not a treatment and it is not another menopause prescription. It is a protected time to practice putting the bags down. → Explore SOMA Circle

Build a toolkit, not a new religion

For some women, their choice is MHT. For some, a non-hormonal prescription. For some, a naturopath and a medication check. For some, iron treatment, more protein and progressive strength work. For others, therapy, pelvic-floor care or a sleep assessment. For many, it is a combination that changes over time.

Your supports should know about one another. Do not build a secret supplement stack in the dark while your GP, pharmacist and naturopath each believe they are looking at the full picture.

You are allowed to use medicine. You are allowed to use natural support. You are allowed to use both. You are allowed to wait while you gather information. You are allowed to stop something that does not suit you, and to change your mind when your body gives you new information.

Helpful contacts (Australia & New Zealand) — where to start looking for qualified support. These are verified professional directories, not personal endorsements. Check qualifications, registration, fees, telehealth availability and whether the practitioner has experience in menopause or midlife women's health.

Menopause-trained GP or clinician (AU & NZ): Australasian Menopause Society — Find a Practitioner
Naturopath or Western herbalist (AU): NHAA — Find a Practitioner
Registered naturopath or medical herbalist (NZ): NMHNZ or NZAMH directory
Pelvic-health physiotherapist (AU): Australian Physiotherapy Association — Find a Physio
Pelvic-health physiotherapist (NZ): Healthpoint pelvic-health directory
Dietitian (AU / NZ): Dietitians Australia or Dietitians NZ
Psychologist (AU / NZ): Australian Psychological Society or New Zealand Psychological Society

A Peek Behind the Curtain

I entered midlife with a body, brain and nervous system that did not fit neatly into generic medical advice.

I also carried the historical fear left by the cancer headlines that followed the early hormone-therapy research, and at the same time I was on immunosuppressant treatment and worried that the wrong botanical could stir up an immune system I was already trying to keep quiet. Whether I looked to mainstream medicine or 'natural' support options, the risk profile felt too high for me to do anything but 'white-knuckle it' through the confusion of symptoms I was experiencing.

It took me nearly eight years of reading, questioning and research before I felt confident making a different choice. For me, the answer was a combination.

I initially chose nutrition and targeted supplements — including vitamin D and K2, magnesium, omega-3, and methylated B12 — because my body and brain had specific deficits and risks discovered through an integrative doctor testing process.

I used gentle swimming in a magnesium pool, weekly strength training, magnesium baths and nervous-system practices, because support is not only something you swallow. A nervous-system-skilled therapist also became a non-negotiable anchor in my toolkit.

And I chose HRT because bone density and mobility were very real concerns after long-term prednisone. The newer evidence on HRT made that option feel more acceptable than continuing some of the treatments I had previously needed for MS. That was my calculation, based on my history, my body, my risk profile — not a rule for anybody else. My body. My toolkit. My choice.

I also tried mainstream medicines for some symptoms. They can help some women enormously. For me, the side effects outweighed the gains, and over time I became determined to identify the root causes rather than shut down the symptoms.

Botanicals have become a strong choice of mine. Lemon balm has emerged as one I value most in my toolkit, as human research has found benefits for calm, stress and mood, without serious adverse effects in the trials reviewed.

My biggest annoyance during the collation of my midlife toolkit was the silent messaging dividing women into opposing camps of either pro-HRT or anti-HRT, pro-medical or pro-natural. In my mind, every woman brings a different body, history and risk profile into midlife. And I am so done with division. We are a tribal species by nature — and it is in community and connection that we gain our greatest support.

When I decided to create SOMA, I was determined never to proclaim one approach superior to another; one woman's perspective and choice inferior to another. I was going to help her gather reliable information, understand what each tool is for and make her own informed choice. This continues to be my stance.

I am pro-information, pro-choice and deeply suspicious of anybody who needs every woman to make the same decision.

Your body. Your toolkit. Your choice.

With warmth, Tarnia Mullan Founder, SOMA Wellness Co.

You do not have to white-knuckle the second half of your life

The goal is not to become an expert in every hormone, botanical, supplement, device and therapy advertised to you. The goal is to know enough to ask better questions, recognise overclaiming and build support around your actual needs.

No single tool has to do every job. No single practitioner must become your guru. And no algorithm gets to decide what womanhood should cost you this month. Your body. Your toolkit. Your choice.

Where SOMA fits — one non-hormonal layer within wider care: The SOMA Duo offers a repeated morning-and-evening botanical ritual for the nervous-system and daily-rhythm layer of a midlife toolkit. → Explore the SOMA Duo

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