In 1994, the WHO proposed to abandon the concept of “menopause” and recommended the term “perimenopause”. Two-thirds of women experience a range of symptoms caused by a decline in ovarian function and a decrease in sex hormones, called perimenopausal syndrome. If the symptoms of perimenopausal syndrome (such as senile vaginitis, urinary tract infections, hot flashes and psychiatric symptoms) are more severe and affect a woman’s normal life and work, or to prevent cardiovascular disease and osteoporosis, which are risk factors, sex hormone replacement therapy can be applied after excluding contraindications. Different methods have to be chosen according to the patient’s different claims, which can be short-term or long-term medication. Combination estrogen and progestin therapy is currently advocated to prevent endometrial hyperplasia and endometrial cancer. For women who have had their uterus removed, single estrogen therapy is possible. In addition, to prevent osteoporosis, oral calcium, vitamin D, calcitonin, sedative drugs for poor sleep, glutathione to regulate plant nerve function, and a-blockers to treat hot flashes are recommended. Black asclepias extracted from plants are also effective in relieving perimenopausal symptoms. For women with perimenopausal symptoms, treatment should be individualized according to the patient’s different conditions and demands, and the treatment given should be safe and effective.