Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:
- Hormone therapy. Estrogen therapy remains, by far, the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose needed to provide symptom relief for you. If you still have your uterus, you'll need progestin in addition to estrogen. Estrogen also helps prevent bone loss. And hormone therapy may benefit your heart if started within five years after your last menstrual period.
- Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered directly to the vagina using a vaginal tablet, ring or cream. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissue. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.
- Low-dose antidepressants. Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may decrease menopausal hot flashes. A low-dose antidepressant for management of hot flashes may be useful for women who can't take estrogen for health reasons or for women who need an antidepressant for a mood disorder.
- Gabapentin (Neurontin). Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can't use estrogen therapy and in those who also have migraines.
- Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis. Several medications are available that help reduce bone loss and risk of fractures.
Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change.
Jan. 24, 2013
- Menopause. National Institute on Aging. http://www.nia.nih.gov/HealthInformation/Publications/menopause.htm. Accessed Dec. 7, 2012.
- Innes KE, et al. Mind-body therapies for menopausal symptoms: A systematic review. Maturitas. 2010;66:135.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/resourceTOC.aspx?resourceID=4. Accessed Dec. 6, 2012.
- Nelson LM, et al. Clinical manifestation and evaluation of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/index. Accessed Jan. 1, 2013.
- Menopausal symptoms and complementary health practices. National Center for Complementary and Alternative Medicine. http://nccam.nih.gov/health/menopause/menopausesymptoms#hed2/. Accessed Dec. 7, 2012.
- Lindh-Astrand L, et al. Effects of applied relaxation on vasomotor symptoms in postmenopausal women: A randomized controlled trial. Menopause. 2012;20:1.
- Colpani V, et al. Association between habitual physical activity and lower cardiovascular risk in premenopausal, perimenopausal, and postmenopausal women: A population-based study. Menopause. 2012;20:1.
- Warnecke E. What works? Evidence for lifestyle and nonprescription therapies in menopause. Australian Family Physician. 2011;40:286.
- Kelley KW, et al. Evaluating the evidence for over-the-counter alternatives for relief of hot flashes in menopausal women. Journal of the American Pharmacists Association. 2010;50:e106.
- For better sex: 3 ways to strengthen your pelvic floor. The Northern American Menopause Society. http://www.menopause.org/for-women/menopauseflashes/for-better-sex-3-ways-to-strengthen-your-pelvic-floor. Accessed Dec. 7, 2012.
- The North American Menopause Society. The 2012 hormone therapy position statement of The North American Menopause Society. Menopause. 2012;19:257.
- MenoNote: Vaginal dryness. The North American Menopause Society. http://www.menopause.org/publications/educational-materials-for-women/menonotes. Accessed Oct. 31, 2012.
- Welt CK, et al. Pathogenesis and causes of spontaneous primary ovarian insufficiency (premature ovarian failure). http://www.uptodate.com/ index. Accessed Jan. 1, 2013.
- Welt CK, et al. Ovarian development and failure (menopause) in normal women. http://www.uptodate.com/ index. Accessed Jan. 1, 2013.
- Marnach ML (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 7, 2013.
- Faubion SS (expert opinion). Mayo Clinic, Rochester, Minn. Jan. 11, 2013.
- Dickson GM. Menopause management: How you can do better. The Journal of Family Practice. 2012;61:138.
- Committee on Gynecological Practice and the American Society for Reproductive Medicine Practice Committee. Compounded bioidentical menopausal hormone therapy. ACOG. http://www.acog.org/Resources_And_Publications/Committee_Opinions/Committee_on_Gynecologic_Practice/Compounded_Bioidentical_Menopausal_Hormone_Therapy. Accessed Jan. 11, 2013.