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INTRODUCTION Perimenopausal women experience profound reproductive and hormonal changes affecting their quality of life. Menopausal symptoms are highly prevalent in these patients, which include hot flashes, depression, anxiety, mood swings, sleep disturbances and vaginal dryness. AIMS & OBJECTIVES To assess the clinical effectiveness of a nutraceutical - ArthTM Perimenopause Multi-Symptom support capsules (Emcure Pharmaceuticals Ltd.) for improving perimenopausal symptoms in women. MATERIAL & METHODS In this 8-week, prospective observational real world evidence study, 30 perimenopausal women aged 40-48 years old with irregular periods and experiencing at least two symptoms of menopause were included. Patients were treated with ArthTM Perimenopause Multi-Symptom support capsule as once daily treatment. The primary endpoint was Changes in score on the Menopause Rating Scale (MRS) and change in mean number of hot flashes per day whereas the secondary endpoint was improvement in Quality of Life. RESULTS Among 30 participants enrolled, 30 participants completed 4 weeks of treatment and included in the interim analysis. Arth Perimenopause Multisymptom Support demonstrated significant reduction in sleep problems, physical and mental exhaustion at Day 7 (P<0.05). Severity of hot flashes significantly reduced (P<0.05) by day 7. It also demonstrated reduction in symptoms from ?Very Severe? category in 100% of participants at one month for all the symptoms such as hot flashes & night sweats, Anxiety, depression, Sleep disorders, Irritability, Physical & Mental exhaustion and Sexual problems. Hot flashes episodes/day were also reduced by 74% at one month. CONCLUSION Arth Perimenopause capsules reduce perimenopause symptoms from day 7 and shows significant improvement from day 15 in hot flashes (severity and episodes/day), sleep disorders, physical and mental exhaustion which were maintained even at one month.