Treatment options for menopausal symptoms include lifestyle changes, non-prescribed treatments and prescribed treatments.
Regular aerobic exercise, such as running and swimming, may help, as may low-intensity exercise, such as yoga. Reducing your intake of caffeine and alcohol may also help to reduce hot flushes and night sweats.
Not every woman chooses HRT for menopausal symptoms. This may be because of your own or family history, or because you have concerns about the safety or side effects of HRT. Treatment options available without prescription are discussed in this section…
Plants or plant extracts, such as St John’s wort, black cohosh and isoflavones (soy products), can help reduce hot flushes and night sweats for some women. However, their safety is unknown, and they can react with other medicines that you may be taking for conditions such as breast cancer, epilepsy, heart disease or asthma. You should always check with your healthcare professional before taking any herbal medicine.
Unlike conventional medicine, there is no legal obligation for herbal medicines to be licensed. Unlicensed products may vary greatly in their actual contents.
If you buy herbal products, look for a product licence or Traditional Herbal Registration (THR) number on the label (see image below) to ensure that what you are buying has been checked for purity. It is advisable to buy remedies from a reputable source.
Alternative therapies such as acupressure, acupuncture or homeopathy may help some women. More research is, however, required on the benefits from these therapies and, if they are used, this should be done with advice from qualified professionals.
You may wish to try a complementary therapy, such as aromatherapy, although the effects of these therapies specifically on your menopausal symptoms are not well known.
Commercially available ‘bioidentical’ hormones are not regulated or licensed in the UK owing to lack of evidence that they are effective or safe to use.
- Hormone replacement therapy (HRT)
See the information on HRT below.
- Non-hormonal medical treatment
Non-hormonal medical treatments, which would need to be prescribed by your doctor, include clonidine or gabapentin for hot flushes.
Menopause can be an extremely emotional and distressing experience. Cognitive behavioural therapy (CBT) is a type of mental health support which is effective for a variety of circumstances. If you have low mood or anxiety related to menopause, you can connect with one of our therapists to get the support you need, from the comfort of your own home.
- Hormone replacement therapy (HRT)
HRT is the most common form of prescribed treatment for menopausal symptoms. It helps to replace the hormone estrogen in your body, which decreases around your menopause. You may sometimes also need other hormones (such as progestogen and testosterone) that your body is no longer producing.
If you are interested in taking HRT, your doctor should discuss the benefits and risks with you before you start the treatment. This discussion should cover both the short-term (over the next 5 years) and the longer term (beyond the next 5 years) benefits and risks for you. You should also be informed about available alternatives to HRT along with their benefits and risks.
- What are the different types of HRT?
The type of HRT that you are prescribed depends on your individual situation. If you have a uterus (womb) then a combination of estrogen and progestogen HRT (combined HRT) would be recommended.
Estrogen alone can cause abnormal thickening of the lining of your uterus, which can lead to bleeding. Adding progestogen will prevent this. Progestogen may be given in the form of tablets, patches or a hormone-containing coil.
If combined HRT is started before you have the menopause or within 12 months of your last period then you will be offered a ‘cyclical’ combined HRT, which should give you regular monthly withdrawal bleeds.
If you start combined HRT more than 12 months after your last period, you may be offered ‘continuous’ combined HRT (bleed-free HRT). You may experience some vaginal bleeding in the first 3 months, but after this, it should stop.
If you have had a hysterectomy, then you will be offered estrogen-only HRT.
Women who notice a low sex drive after the menopause may be offered another hormone called testosterone. This is a hormone linked to sex drive in both men and women.
HRT is available as oral tablets, skin patches, injections, body gel or spray, or vaginal ring, cream or pessary.