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Menopause treatment - what can be done?

Woman attending a GP appointment

Menopause describes the phase of a woman’s life that signals the end of her childbearing years. Monthly periods eventually stop because the ovaries stop producing eggs. This doesn’t happen suddenly; periods tend to become irregular as hormone production becomes erratic. This phase, known medically as the peri-menopause, can last for over two years. Many women find it a difficult time because of annoying symptoms such as hot flushes, cystitis and mood swings, all of which can be helped by menopause treatment.

 

Surveys suggest that 80% of women experience menopausal symptoms and over half of them find menopause very difficult to cope with. However, only about 10% visit their GP to find out if menopause treatment can help.


 

Menopause treatment – who can benefit?

Just because the menopause is a natural process does not mean that women need to go through it without help. Several potential menopause treatments are available and even if you decide to manage without them, just talking through your symptoms with a sympathetic GP can really help.

 

Menopause usually happens around the age of 50 but symptoms can appear any time between the ages of 45 and 55:

 

  • Hot flushes, which can happen any time and last a few minutes
  • Sweating, particularly at night when hot flushes can be frequent
  • Palpitations, the feeling of your heart ‘missing a beat’ or thumping hard in your chest
  • Cystitis, or a feeling of urgency to pass urine
  • Vaginal dryness and discomfort during sex
  • Mood swings, lack of energy and motivation and depression

Menopause treatment and HRT

Most women have heard good and bad reports about hormone replacement therapy (HRT). This form of menopause treatment is worth considering as newer formulations have fewer side effects. HRT is an effective menopause treatment because it replaces natural hormones, restoring the normal, pre-menopausal levels. HRT is prescribed to suit your age and circumstances:

 

  • Women who have had a hysterectomy and also had their ovaries removed are usually offered HRT containing only the hormone oestrogen as their main menopause treatment.
  • If you still have your ovaries and womb and are experiencing periods now and again, you will be offered cyclical HRT, which contains oestrogen and progesterone. This menopause treatment will restore monthly periods but some types allow a bleed only once every three months, just to prevent too much thickening of the womb lining.
  • Post-menopause treatment with HRT is given continuously as there is no need for a bleed to prevent build up of the lining of the womb.

 

You can take HRT as a tablet but it is equally effective when a hormone implant or skin patch is used.

 

Non-hormonal menopause treatments

Non-hormonal menopause treatments can also tackle the individual symptoms of the menopause:

 

  • Tibolone is works in a similar way to HRT but does not contain either of the human sex hormones. This synthetic hormone is really only suitable as a menopause treatment in women whose periods have become very irregular but who are still being troubled by hormonal symptoms. Taking tibolone puts a stop to all periods and is very good at reducing hot flushes, night sweats and psychological symptoms.
  • Clonidine is also used to specifically target hot flushes and sweating. This drug was originally developed for treating high blood pressure but is effective as a menopause treatment in some women.
  • Vaginal lubricants can be bought over the counter as needed and Replens, a vaginal moisturiser is available on prescription. Vaginal dryness does not ease once the menopause is over and this menopause treatment is safe enough to use as long as you need it.
  • Anti-depressants can be prescribed as menopause treatments to tackle hot flushes and sweating and also help to reduce some of the mood swings that are common on some menopausal women. Drugs such as fluoxetine (Prozac®) can be useful for women who are either unsuitable for HRT or artificial hormonal menopause treatments or who don’t want to take hormones.

Alternative menopause treatments

Some women dislike the idea of drugs to deal with the natural event of the menopause. This may explain why so few see their GP about possible menopause treatment options. If you are really against taking medical treatment, there are some alternative ways of coping. Making positive lifestyle changes is worth doing even if you are prescribed HRT or one of the other medical menopause treatments:

 

  • Taking more exercise can reduce the frequency of hot flushes, night sweats and mood swings.
  • Eating a better diet – particularly one that is rich in calcium is a good idea as this will protect against the risk of osteoporosis (brittle bones) after the menopause.
  • Cutting down on alcohol – drinking even a glass of wine or two can make flushing and palpitations much worse.
  • Practicing relaxation techniques can help you deal with the stress of menopause.

 

There are also suggestions that eating more soy based products can help because they contain phyto-oestrogens – substances that mimic human sex hormones. There is not a great deal of experimental medical evidence that they work but Japanese women, whose diet is very high in soy rarely report hot flushes at the menopause.

Menopause treatments to avoid

Women may feel unable to go to their GP and instead opt to buy drugs and treatments advertised over the internet. This is a very bad idea; many preparations are fake and do not contain what they promise. Even herbal preparations sold from websites can be harmful as their content is not properly regulated. If you want to try herbal alternative menopause treatments, your GP is still the best starting point. Many practices now have good links with local alternative medicine practitioners who are properly regulated.

 


Kathryn Senior

Profile of the author

Dr Kathryn Senior is an acclaimed medical journalist who has written over 500 feature articles for leading international journals within The Lancet group. As Senior Writer at Freelance Copy she produces high quality scientific and medical content for websites and printed publications for companies and organisations in the health, medical and pharmaceutical sectors. 


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