Before we begin to discuss the treatment options for menopause, it’s essential to first understand some basics, such as what is menopause? This is the time in a woman’s life when twelve months have passed since her last period. The North American Menopause Society adds, “Menopause is associated with reduced functioning of the ovaries due to aging, resulting in lower levels of estrogen and other hormones. It marks the permanent end of fertility. Menopause occurs, on average, at age 51.”
Menopausal Transition
The years leading up to menopause when women may experience symptoms such as hot flashes, mood swings, difficulty sleeping, etc., is called menopausal transition or perimenopause. These symptoms will vary from person to person and some women report no symptoms at all. According to the National Institute on Aging, “The menopausal transition most often begins between ages 45 and 55. It usually lasts about 7 years but can last as long as 14 years.”
Treatment Options for Menopause
Menopause does not require treatment, but treatment can be considered to ease symptoms and increase comfort during this time if symptoms greatly interfere with daily life.
Treatment often starts with behavioral changes such as:
- Lowering the room temperature
- Using fans
- Dressing in layers
- Avoiding triggers (spicy foods, stressful situations, hot climates)
- Cognitive behavioral therapy
- Weight loss
- Drinking cold beverages
- Exercise
- Breathing Exercises (such as yoga and meditation)
According to The Mayo Clinic pharmaceutical options can include:
- Hormone therapy. Estrogen therapy is the most effective treatment option for relieving menopausal hot flashes, which can be taken via a skin patch or pill or topical cream. Talk to your doctor about the benefits and risks of hormone therapy and whether it's a safe choice for you.
- Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered topically directly to the vagina. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissues. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.
- Low-dose antidepressants. Certain antidepressants (particularly SSRIs like paroxetine or citalopram or SNRIs like venlafaxine) may decrease menopausal hot flashes.
- Gabapentin or pregabalin (Neurontin, Lyrica) have been shown to help reduce hot flashes. These drugs are useful in women who can't use estrogen therapy and in those who also have nighttime hot flashes.
- Clonidine (Catapres, Kapvay). Clonidine, a pill or patch typically used to treat high blood pressure, might provide some relief from hot flashes if other options fail.
- Medications to prevent or treat osteoporosis. Depending on individual needs, doctors may recommend medication to prevent or treat osteoporosis.
- Progesterone. If other treatment options fail or are too high risk for the woman, high dose progesterone can help with moderate to severe hot flashes.
Alternatively, there are natural remedies that may help ease symptoms associated with menopause. These natural options include:
- Black Cohosh
- Soy
- Flaxseed
- Vitamin E
It is important to note that the natural remedies listed above are still being tested and to date, no supplement has consistently been shown to work better than placebo in managing symptoms.
Bioidentical hormone therapy is not recommended.
Consult Your Doctor
If you are beginning to experience symptoms associated with menopause be sure to consult your physician for the best treatment options.