two women wearing face masks looking at a clipboard while discussing menopause treatment options

Menopause Treatment: What Are My Options?

By Christina Hanna, MPH, CHES • Published 06/06/2023

Medically Reviewed by Dr. Tara Scott, MD

We will all experience menopause differently. Our experiences will change as we move from perimenopause to postmenopause. And how we choose to treat and manage our symptoms can also change.

There are many options to help relieve menopause symptoms — from lifestyle changes to menopause hormone therapy (MHT). Start a conversation now with your doctor (or telemed provider) about what treatments may be right for you.

Prescription treatments for menopause

Some treatments must be prescribed and managed by a healthcare provider. They can include:

  • Systemic hormone therapy. Higher dose of estrogen (combined with progesterone in those with a uterus)used to treat many common symptoms of menopause. It’s available in a pill, skin patch, vaginal ring, gel, cream, or spray foam.
  • Low-dose vaginal estrogen. Minimizes the amount of estrogen absorbed by the body. Available in a vaginal ring, tablet, or cream and mostly used to treat vaginal and urinary menopause symptoms.
  • Low-dose antidepressants. Usually used to treat depression, certain low-dose antidepressants have been approved to treat hot flashes for people who do not already have mood or anxiety problems.
  • Non-hormonal medications for symptoms. At this time, there's one FDA-approved medication that addresses menopause symptoms without using hormones. The approved medication targets hot flashes by blocking a brain chemical called neurokinin B (NKB), which works with estrogen to help control body temperature. The imbalance of estrogen and NKB is what can cause hot flashes. To reduce the imbalance, the medication blocks NKB to help reduce the number and intensity of hot flashes.

Talk to your doctor about which treatments may be right for you based on your health history and symptoms.

woman practicing relaxation and stress management techniques in a yoga class to help with her menopause symptoms

Alternative treatment for menopause symptoms

There are complementary and alternative treatments that some people claim may help with menopause symptoms. Most of these do not have strong scientific evidence to back up those claims and have not gone through the FDA’s regulatory and approval process. Please talk to your doctor before giving any of these a try. Some of the treatments that are being studied include:

  • Plant estrogens (phytoestrogens) - estrogens that naturally occur in certain foods
  • Compounded bioidentical hormones – Hormones from plant sources that are chemically identical to the hormones your body produces. These are prepared by a compounding pharmacist and may combine multiple hormones in untested/unapproved combinations and may be administered in nonstandard or untested ways.
  • Black cohosh and other botanical supplements
  • Non-botanical supplements
  • Mind and body practices like yoga, tai chi, and mindfulness
  • Acupuncture
  • Hypnosis
woman preparing a healthy balanced meal in the kitchen to help with her menopause symptoms

Everyday care

Many menopause symptoms are temporary and can be managed without medications. Some of these are activities you may already be incorporating into your routine:

  • Try your best to get enough quality sleep – we know this can be challenging.
  • Practice relaxation and stress management techniques.
  • Eat a healthy, balanced diet.
  • Don’t smoke.
  • Reduce alcohol consumption.
  • Get regular physical activity.
  • Strengthen your pelvic floor through exercise.
  • Improve vaginal dryness and discomfort with water-based or silicone-based lubricants or moisturizers.
  • Be prepared for hot flashes and night sweats. Dress in layers and carry cool water and a fan with you. Figure out if you have triggers for your hot flashes and if possible, avoid them.
  • Schedule regular appointments with a mental health professional.
Last Updated 02/15/2024

REFERENCES

Astellas. (2023). Astellas’ VEOZAH™ (fezolinetant) approved by U.S. FDA for treatment of vasomotor symptoms due to menopause. Accessed 5/19/23 from https://www.astellas.com/en/news/27756

Mayo Clinic. (2020). Menopause. Accessed 1/6/2023 from https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401

National Health Service. (2022). Treatment: Menopause. Accessed 1/6/2023 from https://www.nhs.uk/conditions/menopause/treatment/

Orleans, R.J., Kim, M-J., Guo, J., Sobhan, M., Soule, L., & Joffe, H.V. (2014). FDA approval of paroxetine for menopausal hot flashes. The New England Journal of Medicine, 370: 1777-1779. DOI: 10.1056/NEJMp1402080

Ruddy, K.J. & Loprinzi, C.L. (2015). Antidepressants decrease hot flashes and improve life quality. Menopause, 22(6): 587-588. DOI: 10.1097/GME.0000000000000449

Stubbs, C., Mattingly, L., Crawford, S.A., Wickersham, E.A., Brockhaus, J.L., & McCarthy, L.H. (2017). Do SSRIs and SNRIs reduce the frequency and/or severity of hot flashes in menopausal women. J Okla State Med Assoc, 110(5): 272-274. PMCID: PMC5482277

The American College of Obstetricians and Gynecologists. (2021). The menopause years. Accessed 4/26/23 from https://www.acog.org/womens-health/faqs/the-menopause-years

The North American Menopause Society 2022 Hormone Therapy Position Statement Advisory Panel. (2022). NAMS position statement: The 2022 hormone therapy position statement of The North American Menopause Society. Menopause: The Journal of The North American Menopause Society, 29(7): 767-794. DOI: 10.1097/GME.0000000000002028

U.S. Department of Health & Human Services, Office on Women’s Health. (2021). Menopause treatment. Accessed 1/6/2023 from https://www.womenshealth.gov/menopause/menopause-treatment

U.S. Food and Drug Administration. (2023). FDA approves novel drug to treat moderate to severe hot flashes caused by menopause. Accessed 5/19/23 from https://www.fda.gov/news-events/press-announcements/fda-approves-novel-drug-treat-moderate-severe-hot-flashes-caused-menopause

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