If lifestyle tweaks don’t help, you still have options.
For many people, simple lifestyle tweaks during menopause—like dressing in layers or keeping your environment cool—are perfectly sufficient for dealing with symptoms of perimenopause and menopause. Many are able to get through the transition without needing any medical interventions, but others may need a little extra help.
“If you’re suffering from menopausal symptoms, and you’ve tried lifestyle interventions, and they’re still not helping you … it may be time to see your doctor about different medication options that are available to you,” says Sonal Chaudhry, MD, endocrinologist at NYU Langone Health.
There are several medications available to relieve perimenopausal symptoms, including some over-the-counter options, like water-based vaginal lubricants to relieve vaginal dryness. If OTC products don’t work for you, check in with your doctor to learn about your prescription options.
Hormone Therapy for Menopause
“The most effective way to treat hot flashes and night sweats is hormone therapy,” says Dr. Chaudhry.
Hormone therapy—which is available as pills or patches—is a prescription option used to treat severe, disruptive hot flashes and other symptoms. Since menopausal symptoms are caused by suddenly low levels of estrogen and progesterone in the body, hormone therapy replaces some of these hormones, thus relieving the symptoms.
The benefits of hormone therapy for menopause go beyond keeping your body temperature stable. Here are other perks of hormone therapy, according to Dr. Chaudhry:
Better hair, skin, or body composition
Reduced frequency of hot flashes and night sweats
And lower risk of osteoporosis and colon cancer.
However, like all medications, hormone therapy does come with risks. For example, it may raise the risk of stroke and blood clots for women who are already have risk factors for these health problems. For this reason, hormone therapy is typically prescribed at the lowest dose possible to relieve symptoms.
Non-hormonal Medications for Menopause
“Another class of medications we commonly use to treat menopausal symptoms are SSRIs or SNRIs, which treat anxiety and depression, but they also have a central effect and can reduce night sweats and hot flashes,” says Dr. Chaudhry.
Numerous studies show that both SSRIs and SNRIs can effectively reduce both the frequency and severity of hot flashes for menopausal women, according to a 2017 review from researchers at the University of Oklahoma Health Sciences Center.
These non-hormonal medication options for menopause may be a good option for women who are trying to avoid the risks of hormone therapy.
Localized Estrogen Treatment for Menopause
“If your symptoms are more localized to vaginal or urinary symptoms, local estrogen therapy may be a good choice for you,” says Dr. Chaudhry. “It’s a smaller amount and it’s applied locally.”
Local estrogen—also called topical hormone therapy—comes in the form of a tablet, cream, or ring. They provide a much lower dose of estrogen than regular hormone therapy, but because it’s applied directly to the vaginal area, it only relieves vaginal dryness—not hot flashes, mood changes, or sleep problems.
Which medical treatment for menopause is right for you depends on your symptoms and your health history. For example, because hormone therapy can increase the risk of stroke, your doctor may advise against this option if you have heart disease or high cholesterol, or if you’ve already had a previous stroke.
“If you are having symptoms that you’re troubled by, then it’s important to talk to your doctor, because they may have tools that can help you,” says Dr. Chaudhry.
Menopause treatment. Washington, DC: Office of Women’s Health, U.S. Department of Health and Human Services. (Accessed on September 3, 2019 at https://www.womenshealth.gov/menopause/menopause-treatment.)
Stubbs C, Mattingly L, Crawford SA, Wickersham EA, Brockhaus JL, McCarthy LH. Do SSRIs and SNRIs reduce the frequency and/or severity of hot flashes in menopausal women? J Okla State Med Assoc. 2017 May;110(5):272-4.