How Menopause Is Treated

Menopause may cause a number of symptoms and changes in your body, but while it is not a disease and is simply a natural part of the aging process, many women experience symptoms that are difficult to tolerate.

The most common complaints include vasomotor symptoms—such as hot flashes and night sweats—as well as mood problems, difficulty sleeping, and vaginal dryness. Thankfully, there are many treatments available to help you manage the symptoms of the menopausal transition. They range from prescription medications to lifestyle changes and mind/body practices such as yoga and meditation.

Read on to discover the different treatment options to consider if menopause is disrupting your life.

Senior doctor in conversation with senior woman holding medicine box.


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Home Remedies and Lifestyle

Everyone experiences menopause differently. For some, the symptoms are mild and pass quickly. For others, hot flashes and mood swings can be debilitating. The good news there are a number of lifestyle changes you can adopt to help cope with the changes occurring in your body.

Exercise

Exercise can help ease the transition to menopause by helping to relieve stress and enhancing your quality of life. It may also help with menopausal side effects. According to a study in the journal Maturitas, lifting weights and other resistance training could have a significant impact on hot flashes.

Regular exercise, combining strength training and aerobic exercise, is also an excellent way to stave off weight gain and loss of muscle mass, which can occur after menopause.

If cardio or strength training isn't your thing, you may want to consider a yoga class. Regular yoga practice has been shown to maintain flexibility, help with bone loss, and improve hot flashes.

Diet

Sometimes changing your diet can help relieve menopause symptoms. Limiting the amount of caffeine you consume every day and cutting back on spicy foods can make your hot flashes less severe. Additionally, eating a healthy diet rich in whole foods and grains may lead to weight loss which may in turn reduce vasomotor symptoms.

Plant Estrogen

Much of the evidence supporting the use of isoflavones (plant estrogen) is anecdotal. Although preliminary research does exist, conclusions are often limited by the small sample size and poor study design. There is simply too little evidence to confidently endorse isoflavones as a treatment for any health condition.

Alcohol

Some menopausal people might find that alcohol triggers their hot flashes, and drinking alcohol increases the risk of disturbed sleep, according to research.

Consuming two to five drinks a day (or more) during menopause is considered excessive and may harm your health, according to the North American Menopause Society.

Excess alcohol consumption during menopause is also associated with an increased risk of conditions such as:

Over-the-Counter (OTC) Therapies

A small amount of bone loss after age 35 years is normal. But during the first four to eight years after menopause, people with a uterus lose bone more rapidly. This rapid loss occurs because of the decreased levels of estrogen. If too much bone is lost, it can increase the risk of osteoporosis.

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

OTC products can also treat vaginal discomfort, dryness, or pain. 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.

Prescriptions

While a lifestyle approach to menopausal symptoms is preferred, in some cases your doctor may recommend prescription therapy.

Hormone Therapy

Hormone therapy (HT) is a prescription medicine to help relieve your menopause symptoms, such as hot flashes and vaginal dryness if they are severe enough to disrupt your daily life.

During menopause, your ovaries make very low levels of the hormones estrogen and progesterone. HT replaces some of the hormones no longer made by your ovaries with artificial estrogen and progesterone.

HT is very effective in treating the symptoms of menopause, especially hot flashes, night sweats, and vaginal atrophy. Some people also take HT to prevent bone loss in menopause, which can lead to osteoporosis.

There are many different formulations and concentrations available. Many hormone therapy options contain either a natural or a bioidentical form of estrogen and progesterone.

Bioidentical hormones come from plant sources. They include commercially available products and compounded preparations. Compounded bioidentical hormones are made by a compounding pharmacist from a health care professional’s prescription.

Compounding pharmacies must be licensed, but they do not have to show the safety, effectiveness, and quality control that the Food and Drug Administration (FDA) requires of drug makers. Many of these companies claim that their products are safer than traditional menopausal hormone therapy.

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

In addition to the type and concentration of hormones, there are different forms of HT for you to choose from, depending on your preferences, symptoms, and treatment goals. These include:

  • Oral (pills) which include Bijuva® (as a combination product containing Estradiol, Progesterone), Activella® (containing Estradiol, Norethindrone), Jinteli® (containing Ethinyl Estradiol, Norethindrone), and Prempro (conjugated estrogens and medroxyprogesterone).
  • Transdermal patches a type of hormone therapy that relies on skin absorption of the hormone rather than oral absorption. Because it doesn't have to be absorbed by your intestines, it can be prescribed in lower doses.
  • Topical creams or mists are applied to the skin to deliver estrogen treatment to the bloodstream.
  • Vaginal rings, suppositories, and creams are inserted into the vagina. Higher dosages may relieve systemic symptoms such as hot flashes. Lower dosages target vaginal dryness, which can result in discomfort or bleeding during sexual intercourse and may increase the risk of urinary symptoms.

If you still have a 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.

Is HT Safe for Everyone?

There are certain clinical situations when using hormones is not appropriate. These include:

The risks of HT include coronary heart disease, stroke, venous thromboembolism (clots), and dementia. These risks rise for those over age 60 or who begin HT more than 10 or 20 years after the onset of menopause. Taking HT for longer durations and at higher dosages also may increase health risks.

Non-Hormonal Medication

Some people are not appropriate candidates for hormone therapy, or may wish to try other types of medication to treat menopause symptoms. These can include:

  • Antidepressants: To relieve hot flashes
  • Selective estrogen modulators (SERMs): To relieve hot flashes or pain during sex
  • A daily vaginal insert called dehydroepiandrosterone (DHEA): To relieve pain during sex
  • Clonidine: A seizure medication called gabapentin and a blood pressure medication to reduce hot flashes and ease sleep problems.

Complementary Alternative Medicine (CAM)

Complementary and alternative medicine (CAM) offers options outside of traditional Western medicine. You may choose to seek an integrative approach to treating menopause by combining traditional methods with naturopathic, homeopathic, or Eastern medicine.

Approximately 51% of menopausal people use CAM and more than 60% perceive it be effective for menopausal symptoms. While there is some clinical evidence to support the benefits and safety of some of these options, generally, scientific evidence is mixed and none of the complementary medicines are approved by the FDA. According to one scientific review, there is no consistent evidence to support the safety or benefit of many CAM therapies.

Consult a Doctor

Always check with your doctor before taking supplements, and herbal remedies as they can interact with prescription medications or each other.

Naturopathy and Homeopathy

Naturopathic medicine is a system that uses natural remedies to help the body heal itself. It embraces many therapies, including herbs, massage, acupuncture, exercise, and nutritional counseling. Naturopathic doctors use a variety of healing practices to help your body heal itself, including:

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

However, very little research has been done on these products for menopausal symptoms, so no conclusions can be reached about their effectiveness. Furthermore, specific risks of liver damage have been noted for black cohosh.

It is important to let all your doctors know about any herbal remedies you're taking for menopause.

Chinese Medicine

Chinese medicine is based on the theory that all of the body's organs mutually support each other. Therefore, in order to be healthy, an individual's organs (and their functions) must be in balance. Traditional Chinese medicine uses varying healing techniques, including:

  • Diet
  • Herbs
  • Acupuncture
  • Exercise
  • Energy healing

Many menopausal people find relief from their menopause symptoms through acupuncture. Studies have shown that acupuncture might be a reasonable alternative to hormone therapy for those suffering from hot flashes.

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, a healing system that originated thousands of years ago in India, is based on the notion that good health depends on the balance between mind, body, and spirit. Ayurvedic practitioners use several different healing techniques, including:

  • Nutrition
  • Detoxification
  • Yoga
  • Meditation
  • Massage therapy

Ayurveda is a well-recognized complementary and alternative medicine option. Unfortunately, there is a lack of research on the effectiveness, safety, side effects, and potential drug interactions of Ayurvedic herbal products.

However, some studies suggest that yoga and meditation can provide short-term relief of some symptoms associated with menopause.

A Word From Verywell

You may begin to experience menopause symptoms in the few years before and the years after menopause, most commonly hot flashes, night sweats, and mood problems.

You may benefit from treatment, such as hormone therapy if your symptoms are severe or affect your quality of life. Generally, menopause symptoms can be managed or reduced using over-the-counter remedies and lifestyle adjustments.

You must speak to your primary care physician before taking any new supplements or herbal remedies, as they may interact with the prescription medication you are taking.

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Article Sources
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  1. Berin E, Hammar M, Lindblom H, Lindh-Åstrand L, Rubér M, Spetz Holm A-C. Resistance training for hot flushes in postmenopausal women: a randomised controlled trialMaturitas. 2019;126:55-60. doi:10.1016/j.maturitas.2019.05.005

  2. 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

  3. 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

  4. Jehan S, Masters-Isarilov A, Salifu I, et al. Sleep disorders in postmenopausal womenJ Sleep Disord Ther. 2015;4(5):212.

  5. American College of Obstetricians and Gynecologists. The menopause years. Updated July 2020.

  6. Hill TR, Aspray TJ. The role of vitamin D in maintaining bone health in older peopleTherapeutic Advances in Musculoskeletal. 2017;9(4):89-95. doi:10.1177/1759720X17692502

  7. 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

  8. 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

  9. 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

  10. U.S Food & Drug Administration. Menopause & hormones: common questions. Updated 2019.

  11. American College of Obstetricians and Gynecologists. Compounded bioidentical menopausal hormone therapy. Committee Opinion No. 532. Obstet Gynecol 2012;120:411–5.

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

  13. Cleveland Clinic. Menopause, perimenopause and postmenopause. Updated December 24, 2019.

  14. The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The 2017 hormone therapy position statement of The North American Menopause Society. Menopause. 2017 Jul;24(7):728-753. doi:10.1097/GME.0000000000000921

  15. Johnson A, Roberts L, Elkins G. Complementary and alternative medicine for menopauseJ Evid Based Integr Med. 2019;24:2515690X19829380. doi:10.1177/2515690X19829380

  16. National Center for Complementary and Integrative Health. Menopausal symptoms: In depth. Updated March 27, 2018.

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