Abstract: Objective To investigate the effects of estradiol valerate tablets on menopausal syndrome scores, estrogen level and adverse reactions in patients with perimenopausal syndrome. Methods A total of 86 patients with perimenopausal syndrome in our hospital were divided into two groups. The control group(43 cases)was given medroxyprogesterone acetate, and the study group(43 cases)was given estradiol valerate. The effects of two groups were compared. Results After treatment, the modified Menopausal Syndrome Scale(Kupperman)score in the study group was lower than that in the control group(P<0.05); the total effective rate in the study group was higher than that of the control group(93.02% vs. 76.74%, P<0.05); estradiol(E₂)and progesterone(T)in the study group were higher than those in the control group, while follicle stimulating hormone(FSH)was lower than that in the control group(P< 0.05); the incidence of adverse reactions was 4.65% in the study group and 9.30% in the control group, but no significant difference was found in two groups(P>0.05). Conclusion The application of estradiol valerate in the treatment of perimenopausal syndrome can improve the score of perimenopausal syndrome and level of estrogen, enhance the curative effect and reduce adverse reactions.