Menopause management

Menopausal symptoms

Every woman has a different experience of menopause. Some women have no symptoms at all. Others have symptoms that interfere with their daily life, for example, hot flushes, night sweats, aches and pains, vaginal dryness and mood changes.

Menopausal hormone therapy (MHT)

MHT is the replacement of female hormones oestrogen and progesterone, and sometimes testosterone. MHT must be prescribed by your doctor. MHT helps to reduce menopausal symptoms that are caused by changing hormones before and after menopause.

MHT is the most effective treatment for menopausal symptoms. It’s a safe treatment, with low risks for healthy women aged between 50 and 60 years, or when used within 10 years of reaching menopause. MHT may also help reduce certain health risks, such as osteoporosis and heart disease.

MHT is not recommended if you have had hormone-dependent cancer. Your doctor may also advise you not to use MHT if it could increase your health risks, for example, if you have undiagnosed vaginal bleeding.

Non-hormonal medicines

There are some options available for women who cannot use MHT or prefer

non-hormonal treatments to manage their symptoms. Non-hormonal prescription medicines are normally used for other conditions, but studies have shown they can reduce symptoms such as hot flushes and sweating. Examples of non-hormonal medicines include:

• antidepressants such as venlafaxine, escitalopram, paroxetine and fluoxetine
• gabapentin
• clonidine.

Talk to your doctor about these medicines, including benefits, risks and side effects.

Natural and complementary therapies

Natural therapies are part of a broad range of complementary medicine and therapies (CMT).

Herbs can be used to manage menopausal symptoms. For example, black cohosh and red clover extract. Lemon balm, valerian and passionflower are also used for insomnia, anxiety and fatigue.

But more research is needed to understand the effectiveness and safety of herbal therapies for the management of menopausal symptoms.

It’s best to seek advice from a qualified and experienced women’s health practitioner, such as a herbalist, naturopath or Chinese medicine practitioner, before using herbal remedies.

You can also try other therapies such as hypnotherapy, cognitive behavioural therapy (CBT), mindfulness and acupuncture to help with symptoms.

Healthy living

Reduced oestrogen hormone levels during the menopause transition can have long-term effects on your body (e.g. your heart and bone health). That’s why healthy choices are so important at this stage of life. Also, when you feel healthy you may be able to cope better with menopausal symptoms.

There are many ways to look after yourself during this time. For example:

• eat a healthy diet and exercise regularly
• develop good sleep habits
• reduce or stop drinking alcohol, smoking and other drugs.

You can also try practical things to look after your emotional wellbeing. For example:

• take time for yourself and do things you love
• talk to your partner, close friends or family about how you are feeling
• practise relaxation techniques
• work with a therapist, for example, someone who is trained in CBT.

When to see your doctor

See your doctor if your menopausal symptoms affect your quality of life. It’s important to seek accurate and reliable information before you start any treatment. Your doctor will ask about your individual situation and explain different treatment options so you can make an informed decision.

For more information, resources and references, visit the Jean Hailes menopause web page.