To investigate the efficacy of the Kuntai capsules combined with nilestriol tablets in the treatment of perimenopausal syndromes and on reproductive hormones, a total of 108 patients with perimenopausal syndromes detected by clinical diagnosis in the department of gynecology and obstetrics in Beijing Tongren Hospital were enrolled from January 2018 to June 2019. These clinical subjects were randomly divided into the observation group (n=54) and control group (n=54). The patients in the control group were treated with nilestriol 2 mg once every 2 w and the dosage was changed to 1 mg, twice a month after symptom improvement. The patients in the observation group were treated with oral Kuntai capsules in addition to nilesteriol, 4 each time, twice a day. Both groups were treated continuously for 3 mouths. The curative effect, clinical symptom score and reproductive hormone level before and after treatment were compared between the two groups. The results showed that the Kupperman menopause index and hot flush scores of both groups were significantly decreased from baseline levels. In the 3 mouths after treatment, the Kupperman menopause index in the observation group was lower than that in the control group (p=0.031), but there was no significant difference after 6 mouths (p=0.178). In the observation group, the hot flush score was significantly lower than that of the control group (p=0.05). The results showed that after treatment, the levels of reproductive hormones, follicle stimulating hormone, luteinizing hormone and testosterone and blood lipids, Triglyceride, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol in the two groups changed significantly compared to those before treatment. The levels of follicle stimulating hormone, luteinizing hormone, total cholesterol and lowdensity lipoprotein cholesterol in the observation group were lower than those in the control group, while the levels of serum estradiol and high-density lipoprotein cholesterol in the observation group were higher than those in the control group. Kuntai capsule may be a good alternative therapy for patients who have contraindication or concerns of hormone therapy.