Are there good natural treatments for perimenopause?

Life style. Maintaining a healthy lifestyle including regular exercise, a healthy diet, stress management, and adequate rest will help many women. Although natural products like black cohash or primrose oil have been used, the studies are not convincing. If symptoms are severe, talk to your doctor to see if you would be a candidate for Estradiol and Progesterone which occur naturally in women.
Yes. There definitely are some good natural treatments for perimenopausal symptoms. One of the most popular is a topical or oral natural Progesterone but there are other treatments available depending on the results of your hormone panel. If you are looking for natural solutions you want to schedule an appointment with a doctor who specializes in functional medicine as this is their specialty.
Yes and no. Most herbal supplements don't surpass placebo. Aerobic exercise and caffiene cessation (not just reduction) can be helpful. Stress is a trigger for hotflashes- so reducing it is helpful. Over the counter Progesterone creams are not biologically active (all active hormones are regulated by fda - thus the pulling of HCG diet) and thus only work from placebo effect which is strong (50%).