Home › Approaches › Low-Dose Naltrexone (LDN)
Western
Low-Dose Naltrexone (LDN)
Western medicine — off-label use of an existing FDA-approved medication
Low-dose naltrexone (LDN) uses tiny amounts of an opioid blocker to potentially increase your body's natural endorphin production and calm overactive immune responses. Most research comes from fibromyalgia and autoimmune conditions, where small studies show promise for pain, fatigue, and mood — symptoms that overlap significantly with perimenopause. The safety profile at these low doses (1.5-4.5mg) appears excellent, though menopause-specific studies are lacking.
30-second summary
Low-dose naltrexone (LDN) uses tiny amounts of an opioid blocker to potentially increase your body's natural endorphin production and calm overactive immune responses. Most research comes from fibromyalgia and autoimmune conditions, where small studies show promise for pain, fatigue, and mood — symptoms that overlap significantly with perimenopause. The safety profile at these low doses (1.5-4.5mg) appears excellent, though menopause-specific studies are lacking.
Evidence quality
Overall: Mixed evidence
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What we do not know
We don't know if LDN specifically helps menopause symptoms or if benefits seen in fibromyalgia studies would translate to perimenopausal women. We don't understand how LDN might interact with fluctuating hormones during this transition. Most studies are small and short-term, so we lack data on long-term effects. We also don't know the optimal dosing for perimenopausal symptoms specifically.
How to access this approach
LDN requires a prescription and must be compounded by a specialty pharmacy since commercial naltrexone comes in much higher doses. Look for functional medicine doctors, integrative physicians, or pain specialists who are familiar with LDN protocols. The LDN Research Trust website maintains a physician directory. Expect to start with the lowest dose (1.5mg) and gradually increase. Most insurance doesn't cover compounded medications, so budget $30-60 monthly.
Cost: Compounding pharmacy cost typically $30-60 per month. Practitioner consultation additional.
Important to know
Discuss with a doctor before starting. Complete contraindication with opioid medications. Inform all prescribers you are taking it.
A word from Rose
"I include every approach on this site because real women have found it genuinely helpful — and I take that seriously as evidence even when the clinical trials are limited. The numbers tell you the odds. Your own experience tells you what works for your body. Give it a fair trial, track how you feel, and trust what you observe."
Written by
Rose
Navigating perimenopause · Researcher · Founded rosemyfriend.com
Research basis
PubMed · Cochrane reviews · NICE guidelines · British Menopause Society · The Menopause Society
Read methodology →
Last updated
March 2026
Rose provides evidence-graded educational information — not medical advice. Always discuss health decisions with a qualified healthcare provider. Full disclaimer · About Rose