Treatments for Menopause


Treatment list for Menopause: The list of treatments mentioned in various sources for Menopause includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.

  • Hormone replacement therapy (HRT)
    • Progestin/Estrogen Replacement Therapy (PERT)
    • Estrogen replacement therapy (ERT) - no longer widely used due to side effects; can be used in women without a uterus.
    • Premarin - a form of ERT.
  • Lifestyle changes - unclear if these are specifically treatments for menopause or merely good practice for older women.
  • Alternative treatments
    • Phytoestrogens - these are plant estrogen-like hormones that are similar to human hormones.
    • Soy
    • Isoflavones
    • St. John's wort
    • Black cohosh
    • Chasteberry - also called monk's pepper, Indian spice, sage tree hemp, and tree wild pepper.
    • Ginseng - helpful with general wellbeing but probably not for specific menopause symptoms.
    • Dong quai
    • Evening primrose
    • Valerian root
    • Wild yam - of dubious effect
    • Mexican yam - of dubious effect

Treatment of Menopause: medical news summaries: The following medical news items are relevant to treatment of Menopause:

Treatments of Menopause discussion: HRT refers to the use of prescription drugs to "replace" the hormones that the ovaries quit making at the time of menopause. For many years, to relieve the symptoms of menopause, health care providers prescribed estrogen replacement therapy (ERT). The most common brand name of ERT is Premarin. It was discovered, however, that taking ERT alone raised the risk of cancer in the lining of the uterus (endometrial cancer). Research showed that adding progestin, the artificial form of the hormone progesterone, prevented the overgrowth of cells in the uterus (called hyperplasia) which dramatically reduces the risk of endometrial cancer. Women who do not have a uterus can take ERT alone. ERT usually is taken by pill or skin patch. Hormone replacement therapy (HRT) refers to a combination of hormones used to treat menopausal symptoms, usually estrogen with progestin. Progestin/Estrogen Replacement Therapy is sometimes abbreviated as "PERT." HRT is most always taken by pill.

In general, HRT is a safe and effective way of managing menopausal symptoms and preventing osteoporosis. HRT is generally NOT recommended for women who have the following conditions:

  • Vaginal bleeding of unknown cause;

  • Suspected breast cancer or a history of breast cancer;

  • History of endometrial cancer;

  • History of or active venous thrombosis (blood clots in the veins of the legs or in the lung);

  • Chronic disease of the liver.

Because there are both benefits and risks associated with taking HRT, every woman should consider these in relation to her own health and thoroughly discuss these issues with her health care provider. HRT may protect against risks of heart disease, stroke, and osteoporosis. Preliminary evidence shows that it also may be helpful in preventing Alzheimer's disease, colon cancer, and macular degeneration (age-related vision loss). However, HRT may not be the right choice for everyone since it may cause side effects such as unusual vaginal bleeding, headaches, nausea, vaginal discharge, fluid retention, and swollen breasts. HRT also has been linked to an increased risk in breast and endometrial cancers in some women. Doctors may prescribe different schedules for taking HRT. A woman should discuss the possible benefits, risks, and side effects with her doctor before making a decision. It's also important to know that HRT is not a one-time decision. Pros and cons should be considered in several stages: first, at the time of menopausal symptoms, as a short-term therapy for relief of symptoms; and later, as the symptoms fade as a longer-term regimen for prevention of osteoporosis.1

There are things you can do to help relieve some menopausal symptoms.

  • Hot Flashes - Hot flashes are sometimes brought on by specific things, such as a hot environment; eating or drinking hot or spicy foods, alcohol, or caffeine; and stress. You can try to decrease hot flashes by avoiding these triggers. Dress in layers and keep a fan in your home or workplace. Some women find that a program of regular exercise brings relief of hot flashes and other symptoms.

  • Vaginal Dryness - You can help vaginal dryness and irritation by using an over-the-counter vaginal lubricant. There are also prescription estrogen and replacement creams that your doctor may recommend to help relieve vaginal dryness and pain intercourse. If you have spotting or bleeding while using estrogen creams, you should see your health care provider.

  • Difficulty Sleeping - One of the best ways to get a good night's sleep is to participate in regular exercise - such as walking 30 minutes a day. However, avoid vigorous exercise too close to bedtime. Also avoid alcohol, caffeine, large meals, and working right before bedtime. Many women find that they sleep better after drinking something warm, such as herb tea or a glass of warm milk. Try to keep your bedroom at a comfortable temperature. Also avoid napping during the day, and try to go to bed and get up at the same times every day.


Doctors sometimes prescribe the hormones estrogen and progestin, in a treatment called hormone replacement therapy (HRT), to ease the signs of menopause. It may also protect you against more serious illness in the future. Many women take HRT. Some women should not. It may or may not be the right choice for you.2

Doctors usually prescribe HRT which combines estrogen and progestin (a form of progesterone). Estrogen can and should be used alone (estrogen replacement therapy or ERT) for women who have had their uterus, including the cervix, removed (by hysterectomy).

Estrogen alone comes in many forms. You can use the pill or tablet form, vaginal creams, vaginal ring insert, implants, or shots. There are also patches that stick to the skin. The body absorbs estrogen from the patch through the skin. Progestin usually is taken in pill form, sometimes in the same pill as the estrogen. It is also available as an IUD (intrauterine device), a vaginal gel, and shots.

The form your doctor suggests may depend on your symptoms. For instance, estrogen creams are used for vaginal dryness. The vaginal ring insert treats vaginal dryness and may help urinary tract symptoms, such as problems holding urine. Pills or patches, however, are used to provide additional relief from menopause symptoms such as hot flashes or to prevent bone loss.

There are different schedules for taking HRT in pill form. You could take estrogen every day for a set number of days, add progestin for 10-14 days, and then stop taking one or both for a specific period of time. You would repeat the same pattern every month. This cyclic schedule often causes regular monthly bleeding like a light menstrual period. Or you could take estrogen and progestin together every day of the month without any break. This continuous pattern can stop monthly bleeding after about six months of treatment. However, problem spotting may continue for longer. Talk with your doctor about the schedule that is best for you.2

You may first try to make some changes in the way you live. Start with a nutritious diet. Contact the National Heart, Lung, and Blood Institute for more information about reducing your risk of heart disease . Also, be careful in your use of alcohol and caffeine, and try to avoid stress. For vaginal discomfort, use a water-based lubricant, but not petroleum jelly. Be sure to get a Pap test, mammogram, and pelvic and breast examinations every year.

If you are having hot flashes, try making a diary of when they happen and what may start them. This may help you find out what to avoid. Otherwise:

  • When a hot flash starts, go somewhere that is cool.
  • Sleeping in a cool room may keep hot flashes from waking you up during the night.
  • Dress in layers that you can take off if you get warm.
  • Use sheets and clothing that let your skin "breathe."
  • Try having a cold drink at the beginning of a flash.

In perimenopause, your doctor might suggest birth control pills. These will provide birth control, make your periods more regular, and lower your chance of cancer of the uterus and ovaries. It may also help with symptoms like hot flashes. However, the pill hides the arrival of menopause. When you think you might have reached menopause, you could stop taking the pill for several months to see if you still have a regular period.

Once you have reached menopause, your doctor might suggest estrogen and progesterone, known as hormone replacement therapy or HRT. For women without a uterus, the doctor will recommend estrogen alone. This is called estrogen replacement therapy or ERT. The hormones are usually taken as pills, but can be given as skin patches, creams, or vaginal inserts, depending on a womanís particular needs.

Taking hormones for a short time (less than 5 years) may help relieve any symptoms of menopause. Taking HRT/ERT for more than 5 years will also help delay osteoporosis and may protect against heart disease. It should improve your cholesterol levels and may also help your memory.

However, there are side effects and possibly health risks. This is particularly true if you have liver problems, high levels of triglycerides (a type of fat in the blood), or a history of blood clots. Blood clots and an increase in your chance of developing breast cancer are two risks of HRT/ERT.3

Phytoestrogens are estrogen-like materials found in cereals, vegetables, legumes (beans), and some herbs. They may work in the body like a weak form of estrogen. Some may lower cholesterol levels. Soy, wild yams, and herbs such as black cohosh, dong quai, and valerian root have been suggested to relieve the symptoms of menopause. If you decide to eat a lot more foods with phytoestrogens, be sure to tell your doctor. Any food or over-the-counter product that you use for its drug-like effects could interact with other prescribed drugs or cause an overdose.

The effectiveness of these "natural" estrogens has not been proved. Some plant estrogens are under study now. Scientists want to know whether they can have the same helpful effects as the estrogen doctors now prescribe. Also, just as important, are they safe? Do they have the same risks as estrogen or different ones? Unlike prescription drugs, herbal medicines are not supervised by the FDA. They do not have to be proven safe or effective. In addition, their strength may vary between batches or manufacturers. 3

1. excerpt from Menopause: NWHIC
2. excerpt from Hormone Replacement Therapy Is It For You - Age Page - Health Information: NIA
3. excerpt from Menopause - Age Page - Health Information: NIA

Last revision: June 3, 2003

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