The main menopause treatment is hormone replacement therapy (HRT), although there are other treatments available for your menopause symptoms. Read our guide to the most common menopause treatments below.
What is HRT?
HRT replaces the hormones that are low or missing as a result of the menopause. Most symptoms of the menopause are caused by low oestrogen levels, so this is the most important hormone to replace. If you still have your womb, you will also need a progestogen to protect the lining of the womb.
HRT is extremely effective in relieving menopausal symptoms. It is available in tablet format, skin patches, a gel to rub into the skin or implants.
What are the benefits of HRT?
The main benefit of HRT is that it can help relieve most menopausal symptoms, including hot flushes, brain fog, joint pains, mood swings and vaginal dryness.
It can also help prevent thinning of the bones, which can lead to fractures. This condition is known as osteoporosis and it's more common after the menopause.
What are some common HRT side effects?
HRT is a safe menopause treatment but there are some HRT side effects. HRT can slightly increase the risk of breast cancer and blood clots in some women.
You should discuss whether you have any risk factors with a menopause doctor or nurse.
Are there HRT alternatives?
If HRT isn't suitable for you, or you would prefer not to have it, your GP or menopause doctor may recommend other menopause treatments or lifestyle changes that can help.
Managing hot flushes and night sweats
If you experience hot flushes and night sweats as a result of the menopause, simple measures may sometimes help, such as:
- Wearing light clothing, such as cotton pyjamas
- Keeping your bedroom cool at night
- Taking a cool shower, using a fan or having a cold drink
- Trying to reduce your stress levels
- Avoiding potential triggers, such as spicy food, caffeine, smoking and alcohol
- Taking regular exercise and losing weight if you're overweight
- If the flushes and sweats are frequent or severe, your GP may suggest taking HRT
These medicines can cause unpleasant side effects, so it's important to discuss the risks and benefits with your doctor before starting treatment.
Treatments for mood swings and low mood
Some women experience mood swings, low mood and anxiety, so it's important to look after your mental health during the menopause.
Self-help measures such as getting plenty of rest, taking regular exercise and doing relaxing activities such as yoga and tai chi may help. Other treatments are available in addition to HRT, including cognitive behavioural therapy (CBT).
CBT is a type of talking therapy that can improve low mood and feelings of anxiety. Your GP may be able to refer you for CBT on the NHS or recommend self-help options such as online CBT courses. You may also be able to access these through your employer's Employee Assistance Programme (EAP), if they have one
Antidepressants may help if you've been diagnosed with depression.
Treatments for reduced sexual desire
It's common for women to experience issues with sexual wellbeing during the menopause, including losing interest in sex, but HRT can often help with this. If HRT is not effective, you might be offered a testosterone gel to apply to an area of skin, such as your tummy or the top of your leg.
Testosterone is the male sex hormone, and it can help restore sex drive in some women. It's not currently licensed for use in women, although it can be prescribed after the menopause by a specialist doctor if they think it might help restore your sex drive.
Possible side effects of using testosterone include acne and unwanted hair growth.
Treatment for vaginal dryness and discomfort
If your vagina becomes dry, painful or itchy as a result of the menopause, your GP can prescribe oestrogen treatment that's put directly into your vagina as a pessary, cream or vaginal ring. This can safely be used alongside HRT. You'll usually need to use vaginal oestrogen indefinitely, as your symptoms are likely to return when treatment stops. However, side effects are very rare.
You can also use over-the-counter vaginal moisturisers or lubricants in addition to, or instead of, vaginal oestrogen.
If these treatments aren't successful, we offer MonaLisa Touch®; a gentle treatment for vaginal dryness or pain.
Preventing weak bones
Women who have been through the menopause are at an increased risk of developing osteoporosis, a rheumatic condition which is caused by a lower level of oestrogen in the body.
You can reduce your chances of developing osteoporosis by:
- Taking HRT, although this effect does not tend to last after treatment stops
- Exercising regularly, including weight-bearing and resistance exercises
- Eating a healthy diet that includes plenty of fruit, vegetables and sources of calcium, such as low-fat milk and yoghurt
- Getting some sunlight to trigger the production of vitamin D, which can help to keep your bones strong
- Stopping smoking and cutting down on alcohol
- Taking calcium and/or vitamin D supplements if you do not feel you're getting enough of these
Alternative treatments, such as menopause supplements, vitamins for menopause, herbal remedies and bioidentical ("natural") hormones, are not recommended for symptoms of the menopause. This is because it's generally unclear how safe and effective they are.
Bioidentical hormones are not the same as body identical hormones. Body identical hormones, or micronised progesterone, can be prescribed to treat menopausal symptoms.
Some complementary and alternative therapies can also interact with other medicines and cause side effects.
You should speak to your GP if you're thinking about using an alternative therapy.
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Published on 21 November 2023