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Menopause is a natural, healthy transition that happens with age when your ovaries make less of the female sex hormones estrogen and progesterone, and your periods gradually stop.

You’re considered to be in menopause when you don’t have periods for 12 months. This can happen anytime starting from age 40 to your 50s. Menopause may occur earlier or later than this timeline for some people. The average age of menopause for U.S. women is 52.

The severity of symptoms and how long they last can vary and may start years before you’re in menopause. The early phase when your symptoms begin is called perimenopause.

Common symptoms of menopause include:

Sometimes, menopause symptoms can affect your quality of life and well-being. But there are many types of treatments that can ease and manage symptoms.

In this article, we’ll discuss the different types of menopause treatments and their effectiveness to relieve common symptoms.

There are a variety of treatments, from prescription medications to natural remedies, for relief from menopause symptoms. The type of treatment best for you depends on your symptoms, the benefits and risks of the treatment, and other individual factors your doctor will discuss with you.

Menopausal hormone therapy (MHT)

Menopausal hormone therapy (MHT) is one option to consider when your menopause symptoms are long lasting and more severe.

MHT helps add low levels of estrogen and progesterone that cause some severe symptoms. These hormone medications may be prescribed separately or together depending on your hormone levels, and other reasons such as another health condition you may have.

MHT may be beneficial in reducing symptoms at any age, but it is considered safer to take MHT within 10 years of menopause or before age 60, as compared to 10 years after menopause or age 60.

MHT may be helpful for treating:

  • hot flashes
  • night sweats
  • vaginal dryness
  • painful sex

MHT may also be helpful as a preventive for some long-term symptoms of menopause, such as bone loss from osteoporosis.

There are some studies that show an increased risk of certain types of cancer with hormone treatment. In some cases, MHT may not be suitable for you. Your doctor will explain the risks and benefits of MHT.

Some side effects may include:

Keep in mind that these are not all the possible side effects of MHT medications. Your doctor or pharmacist can tell you more about the exact medication prescribed for you.

MHT is available in different prescription forms, including:

  • tablets (Premarin, Prometrium)
  • injection (Delestrogen)
  • patches (Climara, Estraderm)
  • skin creams
  • gels
  • vaginal creams
  • vaginal rings

Topical hormone therapy

Topical hormone therapy may help vaginal dryness. It comes as a topical cream or spray. Options include:

Topical forms work locally, so less medication is absorbed into your body. This helps lower the risk of side effects.

Vaginal estrogen

During menopause, your body’s estrogen levels drop, and this can lead to vaginal dryness and painful sex. Topical estrogen is available as a cream, ring, or tablet.

Estrogen cream (Estrace, Premarin) is applied two or three times a week to increase the thickness and flexibility of the vaginal lining.

The estrogen ring (Estring) is inserted into the vagina and can last for 3 months.

The vaginal estrogen tablet (Vagifem) is inserted into the vagina twice a week.

Your doctor or pharmacist can provide more information about the benefits and risks of each type of vaginal estrogen for you.

Low dose antidepressants

Low doses of some types of antidepressants may help relieve certain menopause symptoms like hot flashes, night sweats, mood changes.

Studies have shown some selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) are effective for reducing hot flashes and depression. Paroxetine is currently the only SSRI that is FDA approved for hot flashes.

If you’re experiencing serious hot flashes or night sweats along with mood changes due to menopause, ask your doctor whether low dose antidepressants would be appropriate for you.

Some common side effects of SSRIs and SNRIs include:

  • dizziness
  • dry mouth
  • headache
  • sleep problems
  • sexual problems

To learn more about specific side effects of these types of medications, talk with your doctor or pharmacist. They can tell you more about what you can expect with treatment.

Gabapentin

Gabapentin is an anticonvulsant medication that may be prescribed off-label by your doctor to treat hot flashes from menopause. Off-label use is when a medication is used for a purpose other than its approved uses.

It’s not clear how gabapentin works to treat hot flashes. According to a 2020 review, gabapentin has modest benefits in treating hot flashes, but it may not be as effective as estrogen for this use.

Gabapentin is not suitable for everyone due to some serious side effects. Ask your doctor about the risks and benefits of gabapentin for your symptoms.

Some side effects include:

  • nausea and vomiting
  • tremors
  • fever
  • viral infection

Clonidine

Clonidine is a class of high blood pressure medication that may be used off-label to manage hot flashes. There is limited data on its effectiveness in preventing hot flashes. Your doctor may discuss trying clonidine if other medications such as MHT or antidepressants haven’t worked for you. They’ll also let you know if it’s safe for you to take.

Side effects may include:

  • dizziness
  • headache
  • sleep problems
  • blood pressure changes
  • heart rate changes

Osteoporosis medications

Menopause can lead to bone loss from low estrogen levels. Your doctor may suggest bone density testing and taking calcium and vitamin D supplements. In some cases, they may recommend prescription medications to slow serious bone loss.

ACOG recommends screening for osteoporosis in postmenopausal women 65 years and older, and earlier if certain risk factors are present.

Prescription medications include:

  • bisphosphonates (alendronate, ibandronate, risedronate)
  • abaloparatide
  • raloxifene (Evista)
  • calcitonin
  • denosumab (Prolia)
  • estrogen (MHT)
  • romosozumab (Evenity)

Ask your pharmacist or doctor for more information about the side effects of prescription medications to treat or prevent osteoporosis.

There are many practical home remedies that can treat mild or moderate symptoms of menopause. You may need to try different options to see which is effective for you.

Dress in layers, drink water, and eat a balanced diet

If you experience frequent changes in body temperature, it may help to dress in layers to manage sudden hot flashes or night sweats to keep you comfortable.

Avoid synthetic fabrics since they trap heat. Instead, opt for cooler cotton or linen fabrics. Using a fan or chilling mattress pad may also be helpful.

You may also notice increased dryness during menopause from low estrogen levels. Drinking 8 to 12 glasses of water can help prevent dryness and reduce bloating.

Eating a balanced diet can help ease symptoms, manage weight, improve heart and bone health, and preserve muscle mass.

Over-the-counter (OTC) lubricants

Nonhormonal vaginal lubricants and vaginal moisturizers are available in water, oil, plant, natural, or silicone-based options.

They can help with symptoms such as:

  • vaginal dryness
  • irritation
  • itchiness
  • painful sex

Examples include:

  • Replens
  • Eros Aqua
  • K-Y Liquid
  • EROS
  • ID Millennium Lubricant
  • Pink Intimate Lubricants
  • mineral oil
  • almond oil
  • coconut oil
  • hyaluronic acid
  • vitamin E vaginal suppositories

Your pharmacist can provide more information about the pros and cons of different types of lubricants and vaginal moisturizers.

Adequate sleep

Menopause can cause sleep problems. Before trying OTC sleep remedies for temporary use, talk with your doctor. For more severe insomnia, ask about prescription medications for short-term use.

Keep in mind that medications for sleep issues should only be used occasionally. For longer-term relief, consider other lifestyle changes, such as getting regular exercise, practicing deep breathing techniques, and using relaxation therapies to improve sleep quality.

Relaxation techniques and meditation

Therapies such as yoga, meditation, deep breathing, and massage can help reduce stress and anxiety from frequent menopause symptoms.

Relaxation can help manage:

  • hot flashes
  • night sweats
  • insomnia
  • mood changes

You can sign up for a class online or attend an in-person session to learn more about these therapies and which one eases symptoms and improves your mood and well-being.

Pelvic floor exercises

It’s important to keep your pelvic floor strong, because loss of estrogen can weaken this part of your body.

Pelvic floor exercises help with:

  • bladder incontinence
  • bowel incontinence
  • painful sex
  • urinary leakage

Types of exercises include Kegels, yoga, and others. You can also consider visiting a pelvic floor physical therapist to learn how to effectively do pelvic floor exercises.

Avoiding smoking

Smoking can cause menopause symptoms to begin sooner. It can also increase your risk of osteoporosis and other health conditions. If you smoke, now is the time to quit smoking.

Not only will quitting lower your risk of early menopause, but it will also reduce the other negative health effects from smoking, such as heart disease and stroke.

Regular exercise

During menopause, many people gain unwanted weight due to hormonal shifts. Exercise can help manage unwanted weight gain and other menopause symptoms, such as:

  • sleep problems
  • low energy
  • stress and mood changes

Many natural remedies may provide relief from menopause symptoms. You may prefer natural remedies to avoid possible side effects of prescription medications.

But it’s important to know natural products can still cause side effects and even interact with medications. Always talk with your doctor and pharmacist about all the medications, supplements, and alternative remedies you’re taking.

Plant estrogens

Plant-based estrogens, also called phytoestrogens, have properties similar to estrogen. They are found in fruits, vegetables, nuts, and seeds. According to a 2015 research review, plant estrogens can decrease hot flashes caused by menopause.

If you’re interested to learn more about phytoestrogens and their role in reducing menopause symptoms, ask your doctor or pharmacist for more information.

Bioidentical hormones

Bioidentical hormones are lab-made hormones that are similar to natural hormones like estrogen, testosterone, and progesterone. They can be used as a substitute for prescription hormone therapy as a way to increase your body’s estrogen and progesterone levels during menopause.

Bioidentical hormone replacement therapy (BHRT) may help with:

  • hot flashes
  • osteoporosis
  • night sweats
  • vaginal dryness
  • unwanted weight gain
  • mood changes
  • painful sex

BHT products may be custom compounded by a pharmacist or available as Food and Drug Administration (FDA) approved products. They come in different forms (tablets, gels, creams, patches, injection, and vaginal inserts). However, custom compounded BHRT is not FDA-approved and should be used with caution.

Some types of FDA-approved BHRT include:

Soy

Soy is a phytoestrogen used to relieve hot flashes and other symptoms of menopause. If you have mild menopause symptoms, increasing phytoestrogens in your diet may bring some relief.

Eating a plant-based diet with soy-based phytoestrogens such as tofu and tempeh is popular with many people for its nutritional value and health benefits.

Black cohosh

Some people use black cohosh to manage menopause symptoms such as hot flashes, night sweats, and vaginal dryness.

However, there is a lack of clinical evidence regarding its effectiveness. Better quality studies are needed to learn whether black cohosh is an effective supplement for managing some menopausal symptoms.

Talk with your doctor before taking this supplement.

Red clover

Red clover is a type of phytoestrogen with effects similar to estrogen. Some people use it to ease menopause symptoms such as hot flashes, bone loss, and night sweats.

A 2021 research review states red clover has modest effectiveness in reducing the likelihood of hot flashes. More studies are needed to determine the effectiveness of red clover for menopause.

To learn more about this supplement, talk with your doctor or pharmacist.

Wild yam (natural progesterone cream)

Wild yam cream is a natural remedy some people use to ease menopause symptoms like hot flashes, night sweats, and vaginal dryness. However, there is lack of clinical evidence that it improves menopause symptoms.

If you’re interested in trying wild yam cream for your symptoms, ask your doctor for more information about its effectiveness.

If you’re experiencing menopause symptoms that are disrupting your quality of life and health, make an appointment to speak with your doctor. They can evaluate your symptoms and suggest treatment options, including prescription medications if appropriate. If vasomotor symptoms are moderate to severe, then menopausal hormone therapy should be discussed as a treatment option, unless there is a contraindication.

It’s important to discuss when your symptoms started and any other health conditions you may have with your doctor, so they can suggest the best ways to manage your menopausal symptoms. Treatment should be individualized, taking into account other health conditions.

Menopause is a natural life transition that can cause varying symptoms.

Symptoms such as hot flashes, night sweats, vaginal dryness, urinary infections, and others can disrupt your life. Symptoms can last for years, so it’s important to talk with your doctor about ways to find relief.

Depending on your symptoms and the phase of menopause you’re in, there are multiple treatments and therapies available to help ease your symptoms. Consider reading these popular menopause blogs for suggestions and tips on ways to cope.

Ask your pharmacist about effective OTC treatments available for mild symptoms. Don’t take herbs or supplements without consulting your doctor or pharmacist to avoid interactions or side effects.

Remember, while menopause is natural, there are effective ways to manage any symptoms you may have. Reach out to your healthcare professional for guidance on ways to help you feel better.