Menopause management - fact sheet

Menopause is when you have your final period. In Australia, the average age of menopause is 51 years. During the menopause transition, lower levels of the oestrogen hormone can cause a range of physical and emotional symptoms. There are many ways to manage menopausal symptoms, including menopausal hormone therapy (MHT) – the most effective treatment, non-hormonal medications, natural therapies and healthy living.

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. Talk to your doctor if your symptoms affect your quality of life.

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 levels 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 suitable for everyone. It’s recommended you do not start MHT if you are older than 60 years or if you’ve been postmenopausal for 10 years or more. 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 medications

There are some options available for women who cannot use MHT or prefer
non-hormonal treatments to manage their symptoms. Non-hormonal prescription medications may be helpful. They only take around four weeks to be effective, whereas MHT may take six to eight weeks to be completely effective. These medications are normally used for other conditions but studies have shown they can reduce hot flushes and sweating.

Antidepressants

Some antidepressants have been shown to relieve hot flushes. For example, venlafaxine, escitalopram, paroxetine and fluoxetine. Side effects may include nausea, dry mouth, hot flushes, sweats and insomnia. Note, paroxetine and fluoxetine are not suitable for women who are taking tamoxifen for breast cancer treatment as they can reduce its effectiveness.

Gabapentin

Gabapentin is a medication that prevents epileptic seizures and relieves chronic nerve pain. It has also been shown to reduce hot flushes. Side effects may include a rash, dizziness and sleepiness, so it should be taken before bed.

Clonidine

Clonidine is a medication for high blood pressure and migraines. It has been shown to reduce hot flushes. Side effects may include dry mouth, dizziness and drowsiness.

Natural therapies

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

Herbs can be used to manage menopause symptoms. Black cohosh and red clover extract are widely used and have some research supporting their use. Other herbs include lemon balm, valerian and passionflower used for insomnia, anxiety and fatigue. But more research is needed to understand the effectiveness and safety of herbal therapies for the management of menopause 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 hormone levels during the menopause transition can have long-term effects on your body, which is 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, including:

• eating a healthy diet and working towards a healthy weight
• exercising regularly
• developing good sleep habits
• reducing alcohol consumption
• quitting smoking and other drugs.
• take time for yourself and do things you love doing
• be kind to yourself
• 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.

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

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 go to jeanhailes.org.au/health-a-z/menopause