Treatment of menopause symptoms
Are there any treatments for symptoms of the menopause?
There are a number of different treatment options to consider if you're experiencing symptoms of menopause:
A healthy diet and regular exercise programme will go a long way towards minimising the symptoms of menopause and helping to maintain overall good health. It is also a good idea to finally kick any old, unhealthy habits, such as smoking or drinking too much alcohol. Other interventions that may be helpful are to dress lightly and in layers and avoid potential triggers like caffeine and spicy foods.
For vaginal dryness, moisturisers and non-oestrogen lubricants are available. Remaining sexually active may also help to preserve the lining of the vagina.
Treatment with oestrogen and progesterone, called combination hormone replacement therapy (HRT), can be prescribed for women who still have their uterus to reduce the symptoms of menopause and help prevent osteoporosis. Oestrogen alone is prescribed for women who have had a hysterectomy (no longer have their uterus).
Use of HRT for menopause symptoms has become less common since research linked it with a slightly increased risk of developing breast cancer, endometrial cancer, ovarian cancer and stroke.
When deciding on treatment, a woman and her doctor need to weigh up the risks and benefits of any medication.
According to Cancer Research UK, combined HRT increases breast cancer risk more than oestrogen-only HRT. Taking combined HRT may double the risk of breast cancer compared to women who do not use HRT.
The longer a woman takes HRT, the more the breast cancer risk increases. However, after stopping HRT, the risk returns to normal levels after five years.
Breast screening appointments are important for all women, but especially important if taking HRT.
The longer HRT is taken, the risk of ovarian cancer also increases slightly. After stopping HRT, a woman's risk returns to normal after a few years.
With progestogen prescriptions, there is no increased risk of endometrial or womb cancer. However, oestrogen HRT alone does significantly increase the risk of endometrial cancer which is why women who still have their womb are recommended to have combined HRT containing oestrogen and progestogen.
There is some evidence of an increased risk of heart disease and stroke amongst women taking HRT. However, other research suggests longer-term HRT use may reduce a woman's risk of heart failure or heart attack. Currently research has provided conflicting results and it remains unclear precisely what the risk is regarding heart disease and stroke.
Many women may not be candidates for HRT. These women include those with current or past breast or uterine (endometrial) cancer, blood clots, liver disease, stroke, women who may be pregnant, or who have undiagnosed vaginal bleeding.
The current recommendations for women who are candidates for HRT who suffer from severe symptoms of menopause is to take the lowest dose of hormones needed to relieve the symptoms of menopause and/or prevent osteoporosis. It is recommended to limit the use of the hormones to the shortest time period and, as with any prescription medication, HRT should be re-evaluated every 6-12 months. Hormonal patches, creams, gels, and vaginal rings may be alternatives to the traditional pills.
If you are unable or do not want to take hormones, there are other medications that your doctor can prescribe to alleviate some of the symptoms of menopause. These may include antidepressants for mood swings and difficulty sleeping.
Other medications such as clonidine and gabapentin can help to reduce hot flushes related to menopause. These medications may also be used in addition to HRT in some cases. Talk with your doctor about what is best for you.