Prescription Medication for Menopause

Menopause is not a one-size-fit-all kind of journey. Even the type and severity of the most common symptoms, like hot flashes, night sweats, vaginal dryness, mood swings, and sleep troubles vary. That’s why how you choose to treat and manage your symptoms should also be unique.

For some, making lifestyle changes is enough to feel more comfortable. For others, taking prescription medication may be the right choice. Let’s dive into what type of medications are used to treat some of the more common menopause symptoms. Then you can decide if you want to discuss with your healthcare provider if one of these treatments for menopause may be right for your journey.

Hormone therapy for menopause

One of the most well-known medications prescribed to help manage menopause symptoms is hormone therapy. You may also hear it called hormone replacement therapy (HRT) or menopausal hormone therapy (MHT). We will refer to it as menopausal hormone therapy, or MHT.

At a high level, MHT is a medication that contains estrogen and sometimes progesterone that’s used to replace the hormones that your body progressively produces less of as you go through the menopausal transition. The hormones work to ease menopausal symptoms that are caused by the fluctuating levels of hormones. MHT is available in various forms, including oral pills, skin patches, gels, vaginal rings, cream, or spray foam. To learn more about MHT, how it works, and who might benefit, read What is Hormone Replacement Therapy for Menopause?

Many studies have shown that MHT helps with moderate to severe hot flashes, night sweats, and vaginal dryness. It can also help prevent bone loss, which is a concern during menopause. Increasingly lower levels of estrogen can lead to a decrease in bone density. However, it's important to note that MHT may come with certain risks for some people. As a result, it's important to discuss your medical history, lifestyle, and individual risk factors with your healthcare provider before starting any hormone therapy.

Antidepressants

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs) have been found to be helpful in managing mood swings, anxiety, and depression sometimes felt during menopause. These medications work by increasing the levels of certain neurotransmitters in the brain, which can help regulate mood and emotions.

In addition to their emotional benefits, some types of SSRIs and SNRIs have been approved to treat hot flashes for people who do not already have mood or anxiety issues. While they may not eliminate hot flashes, they can reduce their frequency and intensity. This makes them an option for those who are unable to or prefer not to take hormonal medications. Talk to your healthcare provider about risks of antidepressants and whether they may be right for you.

Ospemifene and prasterone

Vaginal dryness and painful sex are common concerns during menopause. A decrease in estrogen causes the vaginal wall to become thin, dry out, and become inflamed. All of these can cause pain during sex. Ospemifene and prasterone are prescription medications specifically designed to address these issues.

Ospemifene is an oral pill that works by acting as estrogen does in the vaginal tissue, helping to alleviate vaginal dryness and discomfort. Prasterone, on the other hand, is a vaginal insert that contains a hormone called dehydroepiandrosterone (DHEA), which can be converted into estrogen in vaginal tissues.

Both medications can help to relieve vaginal symptoms by offering a localized approach to symptom management.

Fezolinetant

This FDA-approved medication addresses menopause symptoms without using hormones. The 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 healthcare provider

Again, before starting any prescription medication to manage menopause symptoms, it's important to talk with your healthcare provider. You might also consider setting up a telehealth appointment with a menopause-trained clinician through Versalie Care, powered by Wheel.

Since everyone’s menopause experience is unique, it’s vital to find a treatment plan that makes the most sense for you. Factors such as medical history, current health, and personal preferences should all be considered when making treatment decisions. With the right approach, you can navigate the menopause journey with greater comfort and confidence.