There are many ways to manage and treat menopausal symptoms, depending on your own unique experience. You might try different options before finding a treatment that works for you. It’s important to seek accurate and reliable information before you start any treatment.
Many women manage mild menopausal symptoms with a healthy lifestyle. Other women with symptoms that affect their quality of life might choose to use medicines and therapies.
Your doctor will consider your individual situation and explain different treatment options so you can make an informed decision.
Menopausal hormone therapy (MHT)
Non-hormone treatments for menopause
Natural therapies for menopause
Related resources
Menopausal hormone therapy (MHT), formerly known as ‘hormone replacement therapy’ (HRT), helps manage menopausal symptoms when they interfere with your daily life.
Menopausal symptoms are caused by lowered levels of certain hormones. MHT is the medical replacement of female hormones oestrogen and progesterone, and sometimes testosterone.
There are many ways to treat hot flushes and vaginal dryness, but no other treatment has been shown to be as effective as oestrogen replacement therapy (a type of MHT).
Oestrogen is the main hormone prescribed to relieve menopausal symptoms. If you’ve had a hysterectomy, this may be all you need.
If you haven’t had a hysterectomy, oestrogen and progesterone are used together, as progesterone reduces the risk of endometrial cancer (cancer of the uterus).
Depending on your situation, your doctor may recommend other combinations of oestrogen and progestogen (including progesterone and other progesterone-like hormones).
MHT can be prescribed in different dosages and methods, depending on your needs and responses. For example, you might be prescribed pills, patches, gel, vaginal creams or an intrauterine device (IUD).
You may need to try different dosages or methods to find what works best for you. Your doctor should help manage this process.
The benefits of MHT far outweigh the risks in healthy women within 10 years of reaching menopause.
MHT can relieve common menopausal symptoms, such as:
MHT can reduce the risk of:
MHT can improve:
Many studies have investigated whether MHT increases the risk of cancers and other illness and disease. The results of some studies led to a significant drop in the use of MHT.
A recent review of evidence on MHT found it is an effective and safe treatment for the relief of menopausal symptoms for healthy women.
The results showed that MHT had low risks for women aged between 50 and 60, but more research is needed to understand how MHT might affect other women’s health issues.
Research shows there are some risks associated with MHT. The risks of hormone therapy differ depending on:
It’s recommended you don’t start MHT if you’re older than 60 or if you’ve been postmenopausal for 10 years or more.
Your doctor may advise you not to use MHT if it could increase your health risks.
For example, if you have:
Everyone responds differently to MHT. Some women may not experience any side effects, while others may have:
Most side effects settle within the first 3 months.
You can take MHT at low doses for as long as you need. Many women have symptoms for around 8 years and one in 4 women have symptoms into their 60s and 70s.
When using MHT in midlife:
It’s important to review the MHT with your doctor each year.
Depending on your situation, if you have premature menopause your doctor may prescribe a higher dose of MHT until about the age of 51.
In this podcast Jean Hailes endocrinologist Dr Rosie Worsley talks about menopause, including the benefits and risks of MHT.
Some doctors prescribe bioidentical hormones, which are mixtures of different hormones made up in compounding pharmacies. The hormones, which are available as capsules, creams, gels, drops and lozenges, are promoted as ‘natural’ and 'exactly like our own', but this is not true.
Hormones are only natural when they are produced in the human body.
Pharmacy-compounded hormones have no government controls or regulations, and little to no high-quality research into their safety and effectiveness.
We do not recommend the use of pharmacy-compounded menopause hormone therapy.
Note that in Australia, doctors can prescribe menopausal hormone therapies (MHT) that are identical to those hormones made in your body. These products have been thoroughly tested for safety and effectiveness.
Talk to qualified health practitioners about the risks and benefits of different treatments for menopause.
Some people can’t use menopausal hormone therapy (MHT), for example, if they've had hormone-positive (oestrogen-receptor-positive) breast cancer.
Some people don’t want to take MHT and prefer different treatment options, like non-hormonal prescription medicines. These medicines can take about 4 weeks to be effective.
Some antidepressants have been shown to relieve hot flushes. For example, venlafaxine, paroxetine, escitalopram and fluoxetine. Side effects may include nausea, dry mouth, hot flushes, sweats and insomnia.
Note that paroxetine and fluoxetine can reduce the effectiveness of some cancer treatment medicines.
Gabapentin is a medicine that prevents seizures and relieves pain for some conditions of the nervous system. It has also been shown to reduce hot flushes. Side effects may include a rash, dizziness and sleepiness, so it should be taken at night.
Fezolinetant is a medicine that helps reduce menopausal symptoms such as hot flushes and night sweats.
Many people use natural therapies to help manage menopausal symptoms and improve their overall quality of life.
While the use of some natural therapies is supported by scientific research, others need more research to prove their effectiveness.
Note that complementary and alternative medicines should be prescribed by a health practitioner trained in their use. It’s important to tell your doctor if you use these, as some herbal remedies can affect other prescribed medicines.
Natural therapies are part of a broad range of complementary medicine and therapies (CAM), including supplements (vitamins, minerals and fish oils), herbal medicine (tea, tablets and liquids) and nutrition. CAM also includes things like relaxation, mindfulness, meditation, aromatherapy, acupuncture and yoga.
Some evidence suggests that the herb black cohosh helps to manage hot flushes.
When the herb St John's wort is combined with black cohosh or passionflower, it may reduce hot flushes and improve your mood.
Some research has shown that hops, which contains a strong phytoestrogen (plant-based oestrogen), may help reduce hot flushes.
If you have breast cancer, ask your health practitioner before using hops.
Red clover also contains phytoestrogens that may help ease hot flushes and night sweats, but it may be more effective for women after menopause.
Some people use different herbs to help with mood, sleep problems and fatigue. But there’s not enough evidence to prove their effectiveness.
Korean ginseng is used to help improve fatigue and reduce stress. It’s one of the most commonly self-prescribed herbs for menopausal symptoms in Australia.
Chamomile is a gentle sedative, and its relaxing action may help to improve sleep and reduce anxiety.
Hops is traditionally used to treat anxiety, stress and poor sleep.
Lemon balm, valerian and passionflower may improve sleep and reduce anxiety.
St John's wort is commonly used for menopausal symptoms such as mild to moderate anxiety, irritability and depressed mood. Talk to your health practitioner before taking St John’s wort as it can affect other prescribed medicines.
Black cohosh may be useful for treating vaginal dryness. Ask your health practitioner about black cohosh pessaries and vaginal cream.
Your practitioner may also recommend including linseed (flaxseed) in your diet. Linseed contains phytoestrogens, which act like oestrogens, to 'plump up' vaginal cells. Check out our linseed, banana and date muffin recipe.
More studies are needed to prove the effectiveness of these natural remedies.
Many factors influence your sex drive, including your relationship with your partner, medicines, health and wellbeing, body image and vaginal dryness, which can cause painful sex. It’s important to address these issues rather than relying solely on herbs to improve your libido.
Some evidence suggests Korean ginseng may improve sex drive in menopausal women. Other herbs used for treating low sex drive include tribulus and maca, but there is limited evidence to prove their effectiveness.
Cognitive behavioural therapy and hypnotherapy can be useful for managing hot flushes, sleep problems and anxiety.
Some people use other complementary therapies to help manage menopausal symptoms. For example, acupuncture, traditional Chinese medicine and nutrition. But there is little evidence to prove their effectiveness.
Learn more about natural therapies, including herbal medicine and complementary therapies.
Get the most out of your medical appointments when discussing menopause and the years surrounding it.
Download our menopause fact sheets in English and in other languages.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
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