Managing the Symptoms of Menopause

Written by Elijah Wolfson and Kristeen Cherney | Published on July 7, 2015
Medically Reviewed by George Krucik, MD, MBA on July 7, 2015


According to the Office on Women’s Health, the average age women officially start menopause (or experience stopped periods) is 51. But symptoms can start early. Throughout perimenopause and menopause, the levels of estrogen and progesterone in your body fluctuate as your ovaries try to keep up with your normal levels of hormone production. This fluctuation is what causes symptoms like hot flashes, mood swings, sleep problems, bone loss, problems concentrating, and others. Learn more about these common menopause symptoms, and how to deal with them to improve your overall quality of life.

Managing Physical Changes

Hot Flashes

Phytoestrogens are plant-derived hormones that can partially reverse the hormonal changes that occur due to menopause. Soy-based foods contain high levels of phytoestrogens, so eating lots of tofu and soy sauce can be helpful. Other supplements in this category include: 

  • black cohosh
  • wild yam
  • dong quai
  • licorice
  • red clover 

Take care when using these, as herbal supplements are not regulated by the FDA. 

Exercise also eases hot flashes by lowering the amount of circulating follicle stimulating hormone (FSH) and luteinizing hormone (LH). Aim for at least 20 minutes, three times a week. In addition, acupuncture and acupressure have been shown to limit hot flashes for some women.

You should also avoid triggers that can make you hotter. These include hot beverages, spicy foods, and alcohol. Stay as cool as possible by dressing in layers and keeping water on hand.

Breast Tenderness

Tenderness and swelling of the breasts are also symptoms of menopause. Non-steroidal anti-inflammatory drugs (Ibuprofen, naproxen) can help decrease both swelling and pain. Although it has some negative side effects, testosterone replacement can be effective in reducing severe breast pain. Some herbs are also being studied for potential relief:

  • Black currant oil is extraordinarily high in vitamin C and is also rich in many other nutrients. It can greatly ease breast tenderness.
  • Evening primrose oil is used in some European countries to ease breast pain.
  • Flaxseed (not flaxseed oil) has been shown in preliminary studies to reduce breast pain.

Vaginal Dryness

Vaginal dryness can potentially interfere with your sex life. Over-the-counter lubricants such as KY Jelly can be used prior to sexual intercourse. Others, like Replens, are meant to be applied on a daily basis. Sesame seed oil can also be used as a topical ointment to ease dryness.

Vaginal estrogen cream and sustained-release vaginal estrogen rings both deliver low doses of estrogen to the inside of the vagina. Estrogen can be very effective in treating dryness, but it may increase your risk of dangerous conditions such as:

  • stroke
  • blood clots
  • heart attack
  • breast cancer 

For this reason, you should use the lowest dose of estrogen possible.

Loss of Libido

Menopause often causes women's bodies to stop producing testosterone, a hormone that is believed to be important in the formation of sexual desires and drive. Testosterone replacement therapy is sometimes used to treat sexual arousal disorders. However, it can have serious side effects (similar to those of estrogen therapies), so consult with your doctor.

The following nonmedical treatment strategies may also help: 

  • lubricants
  • sensual massages
  • Kegel exercises
  • therapy 

Though not well studied, the herb yohimbine (yohimbe bark extract) is believed by some to increase vaginal blood flow and boost female libido.

Urinary Incontinence

Urinary incontinence can be embarrassing, but it is also a common symptom of menopause. Do Kegel exercises to strengthen the pelvic floor muscles. These exercises can greatly improve urethral control. 

Learn more about Kegel exercises »

Avoid alcohol and caffeinated beverages, which can over-stimulate your bladder. Limit spicy foods, which can also cause bladder issues. 

A pessary is a ring made of rubber, plastic, or silicone, which you insert inside your vagina, above the bone. Pessaries help keep your organs in proper alignment and decrease leakage. You may also consider asking your doctor about prescription medications to help urinary incontinence.

Managing Other Changes

Mood Changes

Significant hormonal changes can impact your mood. Irritability, depression, and overall moodiness are the most common effects. The following solutions can help: 

  • regular, daily exercise (not too close to bedtime)
  • meditation or yoga
  • avoid alcohol
  • keep caffeine consumption to mornings only
  • eat more fruits and vegetables for a better overall mood

Certain herbs may also help, but more studies are needed to prove their safety and effectiveness. Talk to your doctor about these possible mood-boosters: 

  • St. John’s Wort
  • garden sage
  • ginseng
  • black cohosh
  • dong quai

Problems Concentrating and Memory Loss

Memory problems are often perceived as occurring with “old age,” when in fact hormones can often be the cause. The following can help improve your concentration and fight memory loss:

  • Ginkgo biloba has been used medicinally for thousands of years, and modern science has shown that it may be useful in treating problems with loss of memory and dementia. Other recommended herbal supplements include sage and ginseng.
  • Taking up a mind-exercising hobby such as Sudoku, crosswords, puzzles, or model building can help keep your mind sharp and active.
  • Lifestyle changes, such as decreased alcohol and caffeine intake, eating more fruits and vegetables, and getting regular exercise can also help.
  • Get adequate sleep to improve short-term memory.

Insomnia and Sleep Problems

During menopause, it seems like you’re always tired. To make matters worse, hot flashes and other symptoms keep you up at night. Consider the following to help you get a better night’s sleep: 

  • regular exercise (avoid working out in the evenings)
  • avoid taking naps
  • drink chamomile tea at bedtime
  • ask your doctor about using supplements like passion flower or valerian 

Practicing good sleep hygiene is always the first step to better sleep.

Preventing Future Medical Concerns

High Cholesterol

Regular exercise and a low-fat, low-calorie diet are the best ways to keep your cholesterol in check. Eliminate foods high in animal fat from your diet and try to get 20 to 30 minutes of aerobic exercise at least three times a week.

Phytoestrogens may also partially reverse the changes in your cholesterol caused by the hormonal shifts associated with menopause.

Bone Loss

The first step in preventing menopause-related bone loss is to increase the amount of calcium and vitamin D in your diet. 

Check out these 10 bone-building recipes that are packed with these two supplements »

There are also a number of prescription medications for bone loss. Bisphosphonates (such as Fosamax) are a new class of non-hormonal drug that can slow bone breakdown. Calcitonin is a hormone administered via nasal spray that also slows bone breakdown. Some selective estrogen receptor modulators (SERMs) have also been shown to effectively treat menopause bone loss. Talk to your doctor to learn if any of these drugs are right for you.

HRT: Is It Right for Me?

Hormone replacement therapy (HRT) is a regimen of medications containing female hormones. The idea is to replace those that the body no longer makes after menopause. Usually it includes estrogen and progestin (a man-made version of progesterone). Since the symptoms of menopause are caused by fluctuating hormone levels, this may be very effective at easing nearly every menopausal symptom. 

For years, HRT was the standard treatment for these symptoms. However, according to the Office on Women’s Health, it may increase your risk of breast cancer, heart disease, and stroke. Ask your doctor whether HRT is right for you.


Once you hit menopause, you may be counting down the days to postmenopause, a time where menopause has ended. However, you still may not be completely symptom-free. There isn’t a definitive timeline when menopause symptoms begin and cease. Your experience will be largely based on genetics. Learning how to cope with your symptoms now can bring you months of comfort as you transition to the next phase of your life.

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