Menopause
Treatment
The type of treatment will be tailored to your symptoms, medical history and your preferences. Your GP may suggest treatment with, or without hormone replacement therapy (HRT).1,2
Remember that most drugs can cause side effects, so always ask your GP to explain the benefits and risks of each treatment.1,2
Hormone replacement therapy (HRT)
This treats the most common menopausal symptoms, including hot flushes and night sweats, vaginal dryness and itching, and recurrent urinary infections.1,2
HRT contains the hormone oestrogen on its own, or is combined with another female sex hormone called progestogen.1,2
A review of randomised trials showed a 75 percent reduction in flushes - 18 fewer per week - with HRT compared with a 50 percent reduction in women who took a placebo.3
It comes in tablets, patches, gels and vaginal cream and dosage depends on the stage of menopause and symptoms.1,2
For more detailed information about risks and benefits, go to our HRT pages
Tibolone
Tibolone is a synthetic steroid that mimics the hormones oestrogen and progesterone. It works in a very similar way to HRT and treats symptoms, such as hot flushes, night sweats and can help prevent spine fractures. It may also improve sexual problems, including loss of libido.1,2
It's used as an alternative to traditional combined HRT for post-menopausal women who want to end their periods.1,2
Risks include small increased risks of breast cancer, cancer of the womb and stroke. It's not suitable for women over the age of 60.1,2
Progestogen tablets
HRT usually refers to replacing the oestrogen hormone but progestogen hormone has also been shown to reduce flushing in some women, although to a lesser extent than oestrogen.1,2
There are fewer risks in taking progestogen hormone than oestrogen.1
Antidepressants
These drugs are normally prescribed for depression but they can help to treat hot flushes.1,2
They are widely used for reducing flushes in women who have had breast cancer.6
Some common ones include imipramine, nortriptyline, fluoxetine and sertraline.6
Side effects can include dry mouth, fluid retention, blurred vision, constipation, weight gain among others.6
Clonidine
This drug is sometimes prescribed to treat hot flushes and night sweats but is usually prescribed for high blood pressure and migraine.6
You'll need to take it for a trial period of two to four weeks. If your symptoms don't improve during this time, or if you experience side effects, you should stop treatment and visit your GP.2
Side effects include drowsiness and dizziness.2
Gabapentin
Gabapentin is usually used to control epileptic fits and pain but research has shown that it may ease hot flushes.1
It may also ease aches, pains and paraesthesia (burning or prickling sensation) which some menopausal women suffer.1
Possible side effects include dizziness, tiredness, tremor and weight gain.1
Vaginal lubricants
Your GP can prescribe a vaginal lubricant, or moisturiser, to help alleviate dryness.1,2 or these can be bought from your pharmacy.
Alternative therapies
Some women have been concerned about the health risks of taking HRT and have turned to alternative treatments to ease symptoms.7
But it's worth bearing in mind that there are very few scientific studies to show that complementary and herbal therapies can help menopausal symptoms.7
Popular herbal remedies include black cohosh, but a study in 2006 found that it worked no better than placebo for relieving menopausal hot flushes. 1
Phytoestrogens
These are plant products that are found commonly in soya products.1,2
Phytoestrogens work like a weak form of oestrogen and limited clinical trials have shown that they can reduce hot flushes.8
Observational studies on women in Japan and Asia, whose diets are rich in phytoestrogens, also seem to show that they don't suffer such severe symptoms as women in the west. 1
Lifestyle changes
You may be able to ease your symptoms, if they're mild, by making changes to your lifestyle and diet.1,2
The Royal College of Obstetricians and Gynaecologists advises that regular aerobic exercise such as swimming and running may help with flushes, as can reducing your intake of caffeine and alcohol.9
Advice includes:1,2
- Wear lighter clothing
- Keep your bedroom cool at night
- Reduce your stress levels
- Avoid potential triggers, such as spicy food, caffeine, smoking and alcohol
- Try to get plenty of rest if you suffer mood changes
- Try relaxation exercises, such as yoga
References
- Menopause Matters, clinician-led website
(http://www.menopausematters.co.uk/menopause.php) - NHS Clinical Knowledge Summaries
(http://cks.library.nhs.uk/menopause/background_information/
association_of_symptoms_with_menopause#-292420) - British Medical Journal, Clinical Review, Managing the Menopause 2007
(http://www.bmj.com/cgi/content/full/334/7596/736?grp=1)
- Lancet. 2008 Mar 1;371(9614):760-70. Menopause. Review
(http://www.legeforeningen.no/asset/38157/1/38157_1.pdf)
and American Psychosocial Oncology Society
(http://www.apos-society.org/professionals/clinical/abstract.aspx?id=11 and Nelson H); - British Menopause Society
(http://www.thebms.org.uk/factdetail.php?id=3) - Phytoestrogens in the Management of the Menopause
(http://www.obgynsurvey.com/pt/re/obgynsurv/abstract.00006254-200205000-
00023.htm;jsessionid=JTyG7p1C24h5g34ph2B1WRx1WjbvqDSQYQQGpTn2V
jfkGzWdFh1k!-1922286307!181195628!8091!-1) - Royal College of Obstetricians and Gynaecologsts
(http://www.rcog.org.uk/index.asp?PageID=1561)
