6 Popular Menopause Treatment Options, Explained
Menopause is a natural, normal, and expected part of life. Though women tend to experience some uncomfortable symptoms as their bodies go through this change, they don’t actually have to be treated. In fact, you could choose to just wait it out until you’ve made the transition.
Still, many women want to lessen and prevent menopause issues like hot flashes, mood swings, vaginal dryness, and painful sex. Whether you choose to do so will likely depend on how much these unpleasant symptoms affect you.
“The type and severity of symptoms varies drastically—anywhere from barely noticeable to complete disruption of quality of life,” says Sara Twogood, M.D., a board-certified ob/gyn in Los Angeles and co-founder of Female Health Education.
You have many choices to help you through menopause, and it’s a good idea to discuss your options with your doctor and review them yearly. Your treatment may change over time; medications may need to be adjusted or stopped based on your symptoms.
“Quality of life is everything,” says Sherry Ross, M.D., a board-certified ob/gyn at Providence St. Joseph’s Women’s Health Center in Santa Monica, California. “It’s important to try and manage the infuriating symptoms of menopause, especially when it comes early.”
Hormone Replacement Therapy
Hormone replacement therapy (HRT) is a medication that replaces the hormones your body stops making when you’re going through menopause—estrogen, progesterone, and testosterone.
Estrogen therapy and combined estrogen and progesterone therapy are two types of HRT. Because estrogen alone increases uterine cancer risk, estrogen therapy alone is only recommended for people who don’t have a uterus.
“HRT is recommended when menopausal symptoms are disruptive and affect a women’s quality of life,” says Ross. She says that for low-risk women, HRT can reverse early menopausal symptoms like hot flashes, sweating, insomnia, depression, anxiety, apprehensive feelings, fatigue, poor concentration, memory loss, vaginal dryness, and heart palpitations. It can also protect against bone loss and colon cancer.
HRT comes in forms similar to birth control. Options include: pills; patches; vaginal rings, suppositories, and creams; and topical creams or mists. HRT can have some side effects, including sore and tender breasts, headaches, upset stomach, bloating, and constipation. Typically, issues are mild and disappear after a few months.
HRT does pose some risks, however. It may increase your risk for blood clots, breast cancer (if taken long-term), uterine cancer, and gallbladder disease. HRT may not be right for you if you have a personal history of breast, ovarian, or endometrial cancer; a strong family history of breast cancer; or, a history of blood clots, strokes, heart disease, liver disease, or untreated high blood pressure, says Ross.
Moderation is key. “It’s best to use HRT for the shortest amount of time and at the lowest dose, under the guidance of a menopause specialist,” says Ross. Still, HRT does have a silver lining, if you’re a good candidate for it. “It can be the absolute best option for some patients,” says Twogood.
Increasing evidence has found that some antidepressants may help alleviate menopausal symptoms, such as hot flashes and night sweats.
“As long as the benefits outweigh the risks, it’s a treatment option worth exploring,” says Ross. Side effects can include weight gain and low libido, which are already common issues in menopausal women. “You may also have occasional dizziness, so it may not mix with some medications, and you may feel emotionally blunted,” says Twogood.
While antidepressants are beneficial for some people, you want to be sure you’ve disclosed your full health history, including your mental health with your doctor. “Antidepressants can actually make other mental-health conditions worse,” says Monica Grover, D.O., a board-certified gynecologist at VSPOT Sexual Health Spa in New York City.
Also, you should consult your doctor any time you’d like to stop taking an antidepressant. “Some antidepressants need to be tapered off slowly,” says Kelly Culwell, M.D., an ob-gyn and former medical officer of the women’s health nonprofit Woman Care Global (WCG) in San Diego, California.
Gabapentin (which goes by brand names Gralise or Neurontin) is an oral medication that’s approved to treat seizures, but it also has been found to help reduce the frequency and severity of hot flashes. While it’s not FDA-approved for this use, it can help women who can’t use estrogen therapy for nighttime hot flashes. Side effects include dizziness, headaches, and drowsiness, says Ross.
Clonidine (known as Catapres or Kapvay) is a pill or patch typically used as a high blood pressure treatment. It has been used to treat hot flashes, but isn’t FDA-approved for this use, says Deepali Kashyap, M.D., a board-certified gynecologist with Galleria Women’s Health in Henderson, Nevada.
Common side effects include dizziness, drowsiness, depression, upset stomach, constipation, and headaches. So, it’s not considered a first-line treatment for hot flashes.
“It could be useful if other options aren’t effective,” says Culwell.
Some people turn to complementary and alternative treatments for relief, though not all are backed with scientific proof.
“Every person is different, and some may experience relief with alternative therapies,” says Culwell. Always consult your doctor first, as some alternative therapies may interact with other medications or may not be recommended in people with certain health conditions.
Acupuncture, for example, may help reduce hot flashes and heart palpitations. “This simple, ancient treatment can work well without causing side effects,” says Ross.
Yoga and tai chi can improve strength and coordination and may help prevent falls that could lead to broken bones. You can also try herbal alternatives like black cohosh, passionflower extract, royal jelly, and fenugreek to help manage your symptoms, says Ross. Herbals aren’t FDA-approved, but they can be effective, she says. Always run them by your doctor before taking, since some herbs can have side effects and drug interactions.
There are some everyday habits you can implement that promote good overall health and mood that can also go a long way in easing menopause symptoms.
Maintaining a healthy diet, including enough calcium and vitamin D, may help prevent bone-density changes.
- Getting regular exercise, including weight-bearing activities, which build healthy bones, may help minimize symptoms and promote good overall health and mood.
- Maintaining a healthy weight, or losing weight if you are overweight or obese, will also help your general health and has been shown to reduce symptoms of menopause.
- Avoiding unhealthy habits such as smoking, and limiting alcohol consumption can help you avoid triggering discomforts like hot flashes.
- Getting at least seven hours of sleep nightly can help with a host of issues, including mood swings and stress response.
“A healthy lifestyle goes a long way at any time in your life, but especially with early menopause,” says Ross. “If you’re still waiting to get a handle on any destructive habits, now is the time. Any of them will only make menopause worse. You can make simple adjustments now.”
Also consider finding a therapist or support group to talk with. Therapy can help manage your stress and give you a sounding board to help you get through this transition. “It’s important in helping to maintain a positive outlook,” says Grover. You will get through these physical changes, and it’ll be much easier if you have a little help and support along the way.
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