Menopause is a natural transition that all women go through as they age. It marks the end of a woman’s reproductive years and is officially diagnosed when a woman has not had a menstrual period for 12 consecutive months. The average age for menopause is 51, but it can occur anytime between the ages of 45 and 55.
As estrogen levels decline during perimenopause and menopause, women may experience various symptoms like hot flashes, night sweats, vaginal dryness, difficulty sleeping, irritability, and more. While menopause is a natural process, the symptoms can significantly disrupt a woman’s quality of life. As a result, many women consider treatments to relieve troublesome menopause symptoms.
Hormone Therapy
One of the most effective medical treatments for menopause symptoms is hormone therapy (HT), also known as menopausal hormone therapy or hormone replacement therapy. HT involves taking estrogen, with or without progesterone, to replace the hormones that the body is no longer producing naturally.
There are a few different forms of estrogen and progesterone that can be used:
- Estrogen pills, patches, gels, sprays, and rings
- Progesterone pills, capsules, injections
Research has shown that HT is the most effective treatment for relieving hot flashes and night sweats. It can also help with mood swings, vaginal dryness, and preventing bone loss. However, HT does come with potential side effects like bloating, breast tenderness, spotting, and an increased risk of blood clots, stroke, heart attack, breast cancer, and gallstones.
The risks of HT tend to be lower when it is started within 10 years of menopause beginning. The benefits and risks vary for each woman depending on her health history and when she starts taking HT. Women are recommended to take the lowest effective dose of HT for the shortest amount of time possible. Your doctor can help determine if HT is appropriate for you and the safest regimens to use.
Non-Hormonal Prescription Medications
For women who cannot take hormones, there are some non-hormonal prescription medications that may help certain menopause symptoms:
Antidepressants
Low doses of certain antidepressant medications can help reduce hot flashes. The most commonly prescribed antidepressants for menopause symptoms are:
– Venlafaxine (Effexor XR)
– Paroxetine (Paxil, Brisdelle)
– Fluoxetine (Prozac)
– Citalopram (Celexa)
– Escitalopram (Lexapro)
These medications can take 4-6 weeks to start having an effect on hot flashes. Side effects may include nausea, drowsiness, dry mouth, anxiety, and reduced sex drive.
Gabapentin
Gabapentin (Neurontin) is an anti-seizure medication that can also reduce the frequency and severity of hot flashes. Side effects include dizziness, fatigue, and swelling in the hands and feet.
Clonidine
Clonidine is a blood pressure medication that may decrease frequency of hot flashes, but has more significant side effects like dry mouth, dizziness, drowsiness, and constipation.
Prescription non-hormonal medications can be an option for women who cannot take hormones but need relief from severe menopause symptoms, especially hot flashes. However, these medications do not treat all possible menopause symptoms and may have side effects.
Over-the-Counter Remedies
There are many over-the-counter (OTC) products marketed for relief of menopause symptoms that do not require a prescription. These include supplements, vitamins, moisturizers, lubricants, and cooling products.
Supplements
- Soy isoflavones – Soy contains estrogen-like compounds called isoflavones that may help reduce hot flashes. Available in foods, supplements, or extracts.
- Black cohosh – Derived from the root of the black cohosh plant, this supplement may decrease hot flashes and night sweats. May cause side effects like stomach upset or headache in some women.
- Evening primrose oil – An anti-inflammatory that may help reduce breast tenderness, hot flashes, and mood swings associated with menopause.
- Vitamin E – May decrease occurrence of hot flashes. Recommended daily dose is 400 IU.
- Flaxseed – High in phytoestrogens which can minimize hot flashes. Take 1-2 tablespoons daily ground flaxseed.
The efficacy of these supplements for treating menopause symptoms is mixed. Some small studies show modest improvements while other research indicates they are no more effective than placebo. Supplements are not regulated by the FDA for safety and purity. Discuss use of supplements with your doctor as they may interact with medications.
Moisturizers and Lubricants
Declining estrogen levels commonly cause vaginal dryness during menopause. Over-the-counter vaginal moisturizers and lubricants can provide relief from vaginal discomfort and painful intercourse. These products are available as gels, creams, or longer-lasting vaginal inserts like:
- K-Y Jelly
- Astroglide
- Replens
- Luvena
Use water-based, not petroleum-based, lubricants if using condoms. Silicone-based lubricants last longer but cannot be used with silicone sex toys. Avoid products with potential irritants like flavors, fragrances, and warming/cooling effects.
Cooling Products
To find immediate relief during a hot flash try:
- Cooling towels
- Cold packs
- Gel ice packs
- Handheld mini fans
Wearing layered, breathable clothing and sleeping in cooling sheets and pajamas can also minimize night sweats.
OTC remedies for menopause may provide symptom relief for some women, but results vary. They tend to provide only temporary relief. Check with your doctor before trying supplements as interactions are possible. Prescription medications often work better for bothersome moderate to severe symptoms.
Lifestyle Changes and Home Remedies
Making certain lifestyle adjustments and using home remedies may help women manage menopause symptoms naturally:
Diet
- Eat plenty of fruits, vegetables, whole grains for antioxidants, fiber, and plant estrogens.
- Drink cold beverages, use ice chips, or suck on frozen fruits to cool hot flashes.
- Avoid spicy foods, hot drinks, and alcohol which can trigger hot flashes.
- Cut back on caffeine to minimize hot flashes and palpitations.
- Consider a soy-rich diet to obtain isoflavones that act like estrogen.
Stress Relief Techniques
- Practice deep breathing, meditation, or mindfulness when experiencing symptoms.
- Make time for hobbies, friends, or therapy to manage moodiness and stress.
- Get enough sleep and physical activity to boost endorphins.
- Join a support group to share coping strategies.
Stay Cool
- Layer clothing and wear breathable cottons to allow temperature adjustments.
- Keep your bedroom cool at night; use fans, open windows, or set thermostat low.
- Avoid hot tubs and take cool showers.
Moisturizers and Lubricants
- Use aloe vera gel as a soothing natural moisturizer for vaginal tissues.
- Try coconut or olive oil as natural lubricants for vaginal dryness and discomfort.
Home remedies and lifestyle approaches do not work for all women and may only provide minor relief. But they are safe to try and may make symptoms more tolerable when combined with other medical or complementary therapies.
Complementary Therapies
Many women going through menopause also use complementary or alternative medicine techniques in conjunction with standard treatments:
Acupuncture
Involves stimulating specific points on the body with thin needles. Some studies indicate acupuncture can decrease severity of hot flashes and night sweats.
Cognitive Behavioral Therapy (CBT)
CBT focuses on changing negative thought patterns. It may help improve mood swings, anxiety, and depression associated with menopause.
Hypnosis
Hypnosis guides women into a deep state of relaxation which may reduce menopausal symptoms like hot flashes, trouble sleeping, and stress. Self-hypnosis can be learned.
Yoga and Meditation
Gentle yoga poses combined with meditation and deep breathing provide exercise, stress reduction, and mindfulness tools to better cope with menopause symptoms.
Chiropractic
Spinal manipulation and mobilization techniques may help relieve muscle and joint pain.
Reflexology
Applying pressure to reflex points on the feet that correspond to different glands and organs, like the ovaries and thyroid, may help menopause symptoms.
Massage
Massage promotes relaxation, soothes sore muscles, and increased circulation which can reduce pain and stress associated with menopause.
Complementary approaches are considered safe, with minimal side effects in most cases. They may support overall wellness and provide symptom relief when used with standard menopause treatments. Discuss trying complementary methods with your healthcare provider.
Prescription Estrogen Creams
Low-dose prescription estrogen creams are a safe, effective treatment specifically for vaginal dryness and discomfort during menopause. They deliver estrogen directly to vaginal tissues without entering the bloodstream so there are less safety concerns. Estrogen creams require a prescription and regular gynecologic exams. Brands include:
– Estrace
– Premarin
– Estring
Vaginal estrogen creams begin providing relief after a few weeks of use. Using the lowest dose for the shortest time needed is recommended to avoid potential risks. Side effects are minimal but may include vaginal burning, discharge, or spotting.
Over-the-counter vaginal estrogens are also available. Discuss the products that are safest for your needs with your healthcare provider.
Conclusion
The safest approach for any woman going through menopause is to start with lifestyle changes, home remedies, and safer over-the-counter options. Things like eating a healthy diet, exercising, managing stress, staying cool, using vaginal lubricants, and trying complementary therapies carry little risk and may help minimize symptoms.
Prescription non-hormonal medications, hormones, or vaginal estrogens can then be added as needed for women with moderate to severe symptoms that interfere with sleep and quality of life. Hormone therapy remains the most effective option for relieving hot flashes and night sweats, but carries some health risks that need to be considered.
Every woman’s experience with menopause symptoms and what she considers safe and tolerable is different. Have an open discussion with your doctor about all of your treatment options, including the potential benefits and risks of each based on your health history. Finding the right balance of safer remedies along with medical therapies when needed can help you manage menopause changes smoothly and safely.