Menopause Treatment
With over 15 years of experience in women’s health, Dr. Jadoon’s expertise is nothing short of exceptional. Holding a prestigious Certification of Completion of Training (CCT) in Obstetrics and Gynaecology from Oxford Deanery and an MSc in Healthcare Management, she brings a unique blend of clinical excellence and visionary leadership.
Dr. Jadoon’s work spans the globe – from NHS research to collaborating with the World Health Organization on quality improvement projects. Her research was around implementation of the 10 Group Robson Classification to optimise c-section rate, cementing her status as a thought leader in women’s health.
Treatment for symptoms of the menopause
About this information
This information is for you if you are considering treatment for symptoms of the menopause. It tells you about the available treatment options. It may also be helpful if you are a relative or friend of someone who wishes to have treatment for the symptoms of the menopause.
This information does not cover everything you may wish to know about the menopause. You can access more information through the information hub on menopause and women’s health in later life on the Royal College of Obstetricians and Gynaecologists (RCOG) website at: www.rcog.org.uk/en/patients/menopause.
A glossary of all medical terms used is available on the RCOG website at: www.rcog.org.uk/en/patients/ medical-terms.
Key Points
- The menopause is when you stop having your periods.
- If menopause happens before the age of 40 years, it is called premature menopause or premature ovarian insufficiency.
- Treatment options for the symptoms of the menopause include lifestyle changes, hormone replacement therapy (HRT) and alternative therapies.
- If you wish to consider treatment, your healthcare professional should discuss the benefits and risks of all the available options.
What is the menopause?
The menopause is when you stop having your periods. It happens when your ovaries stop releasing eggs or your ovaries have been removed and the amount of estrogen hormone in your body falls. Most women in the UK have their menopause between the ages of 45 and 55 years, with the average age being 51 years.
Menopause can occur earlier in some women. If it occurs before the age of 40 years, it is known as premature menopause or premature ovarian insufficiency. The time before your last period, when your estrogen levels are falling, is called the perimenopause. This can last from a few months to several years. Around half of all women notice physical and/or emotional symptoms during this time.
The most common symptoms are:
- hot flushes
- night sweats
- vaginal dryness
- low mood and/or feeling anxious
- joint and muscle pain
- loss of interest in having sex.
Every woman experiences the menopause differently. Some experience one or two symptoms, which may be mild, while others have more severe and distressing symptoms. Some women choose to go through the menopause without treatment, while others prefer some form of treatment to manage their symptoms, by using either hormone replacement therapy (HRT) or an alternative treatment.
Do I need any hormone tests before I can start treatment?
If you have symptoms of the menopause and are over 45 years of age, you will not usually need any hormone tests to diagnose menopause. Treatment options are offered based on your symptoms alone.
What are my options for the treatment of menopausal symptoms?
Treatment options for menopausal symptoms include lifestyle changes, nonprescribed treatments and prescribed treatments.
Lifestyle changes
Regular aerobic exercise, such as running and swimming, may help, as may lowintensity exercise, such as yoga. Reducing your intake of caffeine and alcohol may also help to reduce hot flushes and night sweats.
Non-prescribed treatments
Not every woman chooses HRT for menopausal symptoms. This may be because of your own or family history, or because you have concerns about the safety or side effects of HRT. Treatment options available without prescription are discussed in this section.
Herbal medicines
Plants or plant extracts, such as St John’s wort, black cohosh and isoflavones (soya products), can help reduce hot flushes and night sweats for some women. However, their safety is unknown and they can react with other medicines that you may be taking for conditions such as breast cancer, epilepsy, heart disease or asthma. You should check with your healthcare professional before taking any herbal medicine.
Unlike conventional medicine, there is no legal obligation for herbal medicines to be licensed. Unlicensed products may vary greatly in their actual contents.
f you buy herbal products, look for a product licence or Traditional Herbal Registration (THR) number on the label (see image) to ensure that what you are buying has been checked for purity. It is advisable to buy remedies from a reputable source.
Alternative therapy
Alternative therapies such as acupressure, acupuncture or homeopathy may help some women. More research is, however, required on the benefits from these therapies and, if they are used, this should be done with advice from qualified professionals.
Complementary therapy
You may wish to try a complementary therapy, such as aromatherapy, although the effects of these therapies specifically on your menopausal symptoms are not well known.
Bioidentical hormones
Commercially available ‘bioidentical’ hormones are not regulated or licensed in the UK owing to lack of evidence that they are effective or safe to use.
Hormone replacement therapy (HRT)
HRT is the most common form of prescribed treatment for menopausal symptoms. It helps to replace the hormone estrogen in your body, which decreases around your menopause. You may sometimes also need other hormones (such as progestogen and testosterone) that your body is no longer producing.
If you are interested in taking HRT, your healthcare professional should discuss the benefits and risks with you before you start the treatment. This discussion should cover both the shortterm (over the next 5 years) and the longer term (beyond the next 5 years) benefits and risks for you.
You should also be informed about available alternatives to HRT along with their benefits and risks.
What are the different types of HRT?
The type of HRT that you are prescribed depends on your individual situation. If you have a uterus (womb) then a combination of estrogen and progestogen HRT (combined HRT) would be recommended.
Estrogen alone can cause abnormal thickening of the lining of your uterus, which can lead to bleeding.Adding progestogen will prevent this. Progestogen may be given in the form of tablets, patches or a hormonecontaining coil.
If combined HRT is started before you have the menopause or within 12 months of your last period then you will be offered a ‘cyclical’ combined HRT, which should give you regular monthly withdrawal bleeds.
If you start combined HRT more than 12 months after your last period, you may be offered ‘continuous’ combined HRT (bleedfree HRT). You may experience some vaginal bleeding in the first 3 months, but after this it should stop.
If you have had a hysterectomy then you will be offered estrogenonly HRT.
Women who notice a low sex drive after the menopause may be offered another hormone called testosterone. This is a hormone linked to sex drive in both men and women.
HRT is available as oral tablets, skin patches, injections, body gel or spray, or vaginal ring, cream or pessary.
Prescribed treatments
Hormone replacement therapy (HRT)
See the information on HRT below.
Non-hormonal medical treatment
Nonhormonal medical treatments, which would need to be prescribed by your doctor, include clonidine or gabapentin for hot flushes.
Psychological treatments
Cognitive behavioural therapy (CBT) is a type of psychological treatment. You may be offered CBT for low mood or anxiety related to menopause