Menopause symptoms can be bothersome, but treatments are available to help you manage them. For example, one of the more recent treatment advances includes a nonhormonal oral medication to relieve hot flashes.
A common misconception is that menopause is just something you have to “live with” and that there’s nothing you can do about it.
And while you can’t exactly treat menopause, recent advances have made it so that you can manage the symptoms. This can make the menopausal experience more comfortable and help protect your long-term health.
Treatment of menopausal symptoms often involves the use of hormone therapy to reduce symptoms.
Older studies, including a large 2013 study, suggest that combined estrogen and progestin hormone therapy may be associated with serious adverse effects. These include an increased risk of heart disease, cancer, and stroke.
However, a
A 2023 position statement from the North American Menopause Society (now called The Menopause Society) still considers hormone therapy the most effective treatment option for menopausal vasomotor symptoms.
Healthcare professionals are taking a more personalized approach when prescribing hormone therapy based on your individual needs and circumstances.
Your doctor may recommend avoiding hormone therapy if you’re over 60 years old or are at increased risk for heart disease or stroke. To lower the risk for long-term health effects, your doctor may prescribe hormone therapy at a low dose for no more thana few years.
Additionally, people with a uterus shouldn’t take estrogen alone. If you haven’t undergone a hysterectomy and want to try hormone therapy, you’ll need a treatment plan that includes both estrogen and progestin.
Hormone therapy comes in a variety of forms, including:
- oral tablets
- topical patches or gel
- vaginal creams, tablets, or rings
Ask your doctor whether hormone therapy may be right for you.
Bioidentical hormone therapy
Bioidentical hormones are plant-derived hormones such as estradiol and estriol that have the same structure as human hormones. Some people claim that bioidentical hormone therapy is a safer alternative to traditional hormone therapy, but the Food and Drug Administration (FDA) notes that there is
In fact, the FDA doesn’t regulate many of these types of therapies, meaning they may not meet the same quality standards as traditional hormone therapy. They also don’t require the same safety warnings, which may lead people to underestimate the potential risks associated with their use.
It’s also unclear how well these treatments compare with nonhormonal options for menopausal symptoms. A
If you’re interested in trying bioidentical hormone therapy, ask your doctor about your options. An FDA-approved formula of estradiol is available. This is typically taken in combination with progesterone.
Vasomotor symptoms, like hot flashes and night sweats, are some of the most recognized symptoms of menopause. In addition to hormone therapy, a variety of nonhormonal medications can help relieve these symptoms.
Off-label nonhormonal medications
The following table includes examples of nonhormonal medications that may be helpful for menopausal people experiencing vasomotor symptoms. Doctors prescribe these medications off-label, meaning the FDA hasn’t specifically approved them for vasomotor symptoms.
| Type of medication | Examples |
|---|---|
| antidepressants | citalopram (Celexa) escitalopram (Lexapro) venlafaxine (Effexor) desvenlafaxine (Pristiq) |
| blood pressure medications | clonidine (Catapres) |
| anticonvulsants | gabapentin (Neurontin) pregabalin (Lyrica) |
FDA-approved nonhormonal medications
In 2023, the
A 2023 summary of findings from clinical trials suggests that fezolinetant may help reduce the frequency and severity of vasomotor symptoms and improve quality of life.
Paroxetine (Brisdelle), a type of antidepressant called a selective serotonin reuptake inhibitor, is also FDA approved to relieve vasomotor symptoms.
Genitourinary symptoms refer to the uncomfortable or bothersome effects of menopause on the genital and urinary systems. These effects may include:
- vaginal discomfort, burning, or itching
- pain during sex
- urinary infections or urgency
Hormonal therapies such as vaginal estrogen or estradiol rings or creams may help manage genitourinary symptoms. Nonhormonal vaginal moisturizers may be beneficial as well.
The FDA has also approved a few nonhormonal medications for dyspareunia (pain during sexual activity) during menopause:
- ospemifene (Osphena), a once-daily oral medication that may help improve
vulvovaginal health and sexual functionTrusted Source - prasterone (Intrarosa), a once-daily vaginal insert that may relieve symptoms like vaginal dryness and itching
The FDA has approved other medications to manage urinary infections and urgency, regardless of menopause status. If you’re experiencing these symptoms, talk with your doctor.
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In addition to the symptoms discussed earlier, treatment options are available to help manage other symptoms or complications of menopause, including:
It may help to track your menopause symptoms so you and your doctor can find treatments that are right for you.
A variety of hormonal and nonhormonal treatment options are available to treat even the most bothersome menopause symptoms, and research is ongoing into new therapies.
If menopause symptoms are affecting your health or wellness, a healthcare professional can help you find the right treatment options for your specific situation.
