How Menopause Is Treated

Menopause is expected and natural. It is not something that must be treated, but many women do seek menopause treatments to relieve and/or prevent symptoms that result from the significant hormonal changes (especially low estrogen levels) that occur. These shifts can significantly affect quality of life. They can also increase the risk of certain health concerns, and some treatments may be used to manage that risk.

The two most common issues related to menopause that women seek treatment for are vasomotor symptoms and vaginal atrophy.

Home Remedies and Lifestyle

Even if you are coping well with the hormonal changes of menopause, it is a good time to pause and take a look at your current lifestyle. Small adjustments can make the next decades healthy ones.

Exercise

Exercise is important regardless of your age, but it takes on added importance in menopause.

Strength training as well as aerobic-focused exercises can help counteract age-related muscle and bone loss, both of which accelerate after menopause begins. Regular moderate exercise also helps manage the mood disturbances that changing hormone levels can bring.

You may even want to consider joining a yoga class. Regular yoga practice has been shown to maintain flexibility, help with bone loss, and improve hot flashes.

Diet

Choosing the right food in menopause can help you stay healthy and may also help you manage the symptoms caused by your changing hormone levels.

In particular, ensuring that you get adequate protein in your diet can help you maintain and/or build muscle.

If maintaining a healthy weight is challenging for you, and it commonly is for many women at this time, watching your daily caloric intake is another worthy goal.

Limit Your Alcohol Intake

Consuming too much alcohol is not good for you. For many women, it becomes the go-to solution for a stressful day. Unfortunately, the way it works with alcohol is the more you drink the more you need to drink it. Some women are more susceptible to alcohol dependence than others. Consuming too much alcohol can lead to multiple medical problems, including weight gain, malnutrition, depression, and dementia, and it has been linked to an increased risk of breast cancer. In some studies, alcohol has been shown to increase the frequency of hot flashes and night sweats. Try having a hot cup of herbal tea or going for a walk on some days after work instead of automatically raising your glass.

If you think you have developed a dependence on alcohol you should discuss this with your doctor. It is too important for your health to ignore.

Over-the-Counter (OTC) Therapies

Your doctor may recommend vitamin D supplements and possibly calcium supplements to prevent bone loss and lower the risk of osteoporosis.

For vaginal dryness, there are a variety of vaginal moisturizers that you can use every two to three days. You can also use vaginal lubricants during sexual intercourse.

A variety of OTC herbal and natural products are marketed for relief of menopausal symptoms such as hot flashes. These include phytoestrogens, black cohosh, DHEA, dong quai, evening primrose oil, ginseng, kava, melatonin, and wild yam.

However, research is either lacking or so far doesn't show these options to be consistently effective, according to the National Center for Complementary and Integrative Health. In addition, kava supplements have been linked to a risk of severe liver disease.

Always check with your doctor before taking OTC products as they can interact with prescription medications or each other.

Prescriptions

While a lifestyle approach to menopausal symptoms is preferred, in some cases—particularly when OTC options haven't been effective, or you have significant symptoms that such treatments cannot help—your doctor may recommend prescription therapy.

Hormone Replacement Therapy

The menopausal transition and, ultimately, menopause are the result of a gradual loss of ovarian activity. Lowered levels of ovarian hormones are directly responsible for the symptoms and changes that you experience.

Hormone replacement therapy is very effective in treating the symptoms of menopause, especially vasomotor symptoms and vaginal atrophy. In fact, estrogen with or without progesterone is proven to be the most effective treatment of vasomotor symptoms associated with menopause, such as night sweats and hot flashes.

Some women also take HRT to prevent bone loss in menopause, which can lead to osteoporosis.

There are many different formulations and concentrations available. Many hormone replacement options contain either a natural or a bioidentical form of estrogen and progesterone. This is true for most pharmaceutical HRT, not just for compounded formulations.

In addition to the type and concentration of hormones, there are different forms of HRT for you to choose from:

  • Oral
  • Transdermal
  • Topical
  • Vaginal

If you still have your uterus, you will need to take progesterone in addition to estrogen to protect the lining of your uterus from developing endometrial hyperplasia. In certain situations, your doctor may suggest testosterone replacement as well.

Depending on your history and your symptoms, your doctor may also suggest that you try another type of hormonal medication, called a selective estrogen receptor modulator (SERM).

There are certain clinical situations when using hormones is not appropriate. Perhaps you have a personal history of breast cancer or a blood clotting disorder and your doctor has told you hormones are contraindicated. If you are having severe vasomotor symptoms, you may want to consider non-hormonal medications.

Health care has come a long way from the one-size-fits-all approach to HRT of the past; the treatment can now be better tailored to treat your symptoms while minimizing risks. As with any medication, however, there are still risks associated with HRT that should be considered. Often, the benefits outweigh them. A conversation with your doctor can determine if that's the case for you.

Paxil

Paxil (paroxetine) belongs to a class of drugs known as selective serotonin reuptake inhibitors (SSRIs). Research has shown that these drugs, which are used to treat depression, also help relieve the vasomotor symptoms associated with low estrogen levels in non-depressed menopausal women.

Since the hormone changes of menopause can also cause depression, an SSRI may also be an appropriate choice in some women. But these benefits need to be balanced with the side effects of most SSRIs, which include weight gain and decreased sex drive—two issues already common in menopausal women.

Clonidine

Unlike Paxil, which has approval from the U.S. Food and Drug Administration (FDA) for the treatment of vasomotor symptoms, Clonidine is used off-label to treat these issues. Some evidence supports the benefits of this blood pressure medication to reduce hot flashes.

Gabapentin

Like clonidine, gabapentin is not FDA approved for the treatment of hot flashes. It is a medicine used to prevent seizures, but has also been shown to reduce vasomotor symptoms. It is not as effective as estrogen, but is a good option for women who cannot use hormone replacement therapy.

Bioidentical Hormones

Bioidentical hormones have the same chemical structure as the hormones in your body or those chemically produced for HRT, but are isolated from plant sources. They can be found in over-the-counter products as well as prescription preparations made by a compounding pharmacy.

The American College of Obstetricians and Gynecologists recommends FDA-approved hormone therapy over compounded hormone therapy. Bioidentical hormones have not been shown to be safer than traditional hormone replacement therapy, and they carry the same risks.

Vaginal Estrogen

Your doctor can prescribe vaginal estrogen to relieve vaginal dryness, which can result in discomfort or bleeding during sexual intercourse and may increase the risk of urinary symptoms. Vaginal estrogen comes in the forms of cream, tablet, or ring.

Complementary Alternative Medicine (CAM)

Complementary and alternative medicine (CAM) offers options outside of traditional Western or allopathic medicine. Many of these options are based on centuries-old healing practices like Chinese-medicine, Ayurveda, and herbal medicine.

There is some clinical evidence to support benefit and safety of some of these options, but generally, scientific evidence is mixed. According to one scientific review, there is no consistent evidence to support safety or benefit for many CAM therapies.

You may choose to seek an integrative approach combining allopathic with naturopathic, homeopathic, or Eastern medicine.

Naturopathy & Homeopathy

Naturopathic medicine, or naturopathy, is based on the principle that disease is caused by a breakdown in the way the body normally heals itself. Naturopathic doctors use a variety of healing practices to help your body heal itself, including:

  • Clinical nutrition
  • Herbal medicine
  • Homeopathy
  • Acupuncture
  • Light therapy

Some common homeopathic or herbal remedies recommended to treat menopausal symptoms include:

The evidence is limited to support benefit from these herbal remedies. Most of these herbs have estrogen-like activity and interact with many different prescription drugs. If you are taking any herbal remedies for menopause it is important to let all your doctors know about it.

Chinese Medicine

Chinese medicine is an over 3,000-year-old healing practice based on a complex concept of energy balance in the universe and ultimately in the individual. Simply put, when this energy is out of balance disease occurs. Traditional Chinese medicine uses varying healing techniques, including:

  • Diet
  • Herbs
  • Acupuncture
  • Exercise
  • Energy healing

Although a definite benefit is not yet supported by significant scientific evidence, there are reports showing that traditional Chinese medicine helps to relieve the menopause symptoms of:

  • Sleep problems
  • Hot flashes
  • Mood disturbances
  • Aches and pains
  • Memory and concentration problems
  • Decreased sex drive

Some experts suggest that traditional Chinese medicine is an important part of treatment options for menopausal symptoms especially as part of an integrated approach.

Ayurveda

Ayurveda, like Chinese medicine, is an ancient healing practice that is over 3,000 years old. Ayurvedic practitioners use several different healing techniques, including:

  • Nutrition
  • Detoxification
  • Purification
  • Yoga
  • Breathing
  • Massage therapy

Ayurveda is a well-recognized complementary and alternative medicine option. Unfortunately, it is difficult to apply Western research study design to this healing philosophy, so very limited evidence is available to comment on its effectiveness. But that doesn't mean it is not effective in helping to treat menopausal symptoms.

A Word From Verywell

Menopause causes many changes in your body. It is a normal process and not a disease. However, the hormonal changes of menopause can cause unpleasant symptoms and long-term health issues that affect your quality of life. Making simple lifestyle changes and integrating different therapeutic approaches can help you live very well through menopause and beyond.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Cleveland Clinic. Estrogen & Hormones. Updated April 29, 2019.

  2. Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their ManagementEndocrinol Metab Clin North Am. 2015;44(3):497–515. doi:10.1016/j.ecl.2015.05.001

  3. Agostini D, Zeppa Donati S, Lucertini F, et al. Muscle and Bone Health in Postmenopausal Women: Role of Protein and Vitamin D Supplementation Combined with Exercise TrainingNutrients. 2018;10(8):1103. doi:10.3390/nu10081103

  4. Motorwala ZS, Kolke S, Panchal PY, Bedekar NS, Sancheti PK, Shyam A. Effects of Yogasanas on osteoporosis in postmenopausal womenInt J Yoga. 2016;9(1):44–48. doi:10.4103/0973-6131.171717

  5. Caputo F, Vignoli T, Leggio L, Addolorato G, Zoli G, Bernardi M. Alcohol use disorders in the elderly: a brief overview from epidemiology to treatment optionsExp Gerontol. 2012;47(6):411–416. doi:10.1016/j.exger.2012.03.019

  6. Sievert LL, Obermeyer CM, Price K. Determinants of hot flashes and night sweats. Ann Hum Biol. 2006;33(1):4-16. doi:10.1080/03014460500421338

  7. Sunyecz JA. The use of calcium and vitamin D in the management of osteoporosisTher Clin Risk Manag. 2008;4(4):827–836. doi:10.2147/tcrm.s3552

  8. Edwards D, Panay N. Treating vulvovaginal atrophy/genitourinary syndrome of menopause: how important is vaginal lubricant and moisturizer compositionClimacteric. 2016;19(2):151–161. doi:10.3109/13697137.2015.1124259

  9. National Center for Complementary and Integrative Health. Menopausal Symptoms: In Depth. Updated March 27, 2018.

  10. Umland EM, Falconieri L. Treatment options for vasomotor symptoms in menopause: focus on desvenlafaxineInt J Womens Health. 2012;4:305–319. doi:10.2147/IJWH.S24614

  11. Gambacciani M, Levancini M. Hormone replacement therapy and the prevention of postmenopausal osteoporosisPrz Menopauzalny. 2014;13(4):213–220. doi:10.5114/pm.2014.44996

  12. Sood R, Shuster L, Smith R, Vincent A, Jatoi A. Counseling postmenopausal women about bioidentical hormones: ten discussion points for practicing physiciansJ Am Board Fam Med. 2011;24(2):202–210. doi:10.3122/jabfm.2011.02.100194

  13. Kim JJ, Chapman-Davis E. Role of progesterone in endometrial cancerSemin Reprod Med. 2010;28(1):81–90. doi:10.1055/s-0029-1242998

  14. Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their ManagementEndocrinol Metab Clin North Am. 2015;44(3):497–515. doi:10.1016/j.ecl.2015.05.001

  15. Drewe J, Bucher KA, Zahner C. A systematic review of non-hormonal treatments of vasomotor symptoms in climacteric and cancer patientsSpringerplus. 2015;4:65. doi:10.1186/s40064-015-0808-y

  16. Allameh Z, Rouholamin S, Valaie S. Comparison of Gabapentin with Estrogen for treatment of hot flashes in post-menopausal womenJ Res Pharm Pract. 2013;2(2):64–69. doi:10.4103/2279-042X.117392

  17. Whelan AM, Jurgens TM, Trinacty M. Defining bioidentical hormones for menopause-related symptomsPharm Pract (Granada). 2011;9(1):16–22.

  18. Krause M, Wheeler TL 2nd, Snyder TE, Richter HE. Local Effects of Vaginally Administered Estrogen Therapy: A ReviewJ Pelvic Med Surg. 2009;15(3):105–114. doi:10.1097/SPV.0b013e3181ab4804

  19. Johnson A, Roberts L, Elkins G. Complementary and Alternative Medicine for MenopauseJ Evid Based Integr Med. 2019;24:2515690X19829380. doi:10.1177/2515690X19829380

  20. Yu Q. Traditional Chinese medicine: perspectives on and treatment of menopausal symptoms. Climacteric. 2018;21(2):93-95. doi:10.1080/13697137.2018.1434983

Additional Reading

  • American Congress of Obstetricians and Gynecologists (2012). Compounded bioidentical menopausal hormone therapy. Committee Opinion No. 532. Washington, D.C: American College Obstetricians and Gynecologists. 

  • National Center for Complementary and Integrative Health. Menopausal Symptoms: In Depth.

  • North American Menopause Society. (2014). Menopause Practice A Clinician's Guide. Mayfield, Ohio.

  • American College of Obstetricians and Gynecologists (2014). ACOG practice bulletin no.141: Management of Menopausal Symptoms. Obstet Gynecol 2014;123:202-16.