What does “menopause treatment” mean?
What people search for as “menopause treatment” is really about the symptoms menopause brings, not menopause itself. Menopause is a natural stage of life, named once 12 months have passed since your last period; it is not removed the way a disease is. But hot flashes, night sweats, broken sleep, mood swings or vaginal dryness can make everyday life seriously hard. The NHS says some people have many symptoms that noticeably affect their life, while others have very few or none at all (NHS, Symptoms).
That is why the options differ from person to person. Doing nothing, changing only your daily routine, or weighing a prescription option together with your clinician are each a valid path. This page describes the types of options at a headline level; which one suits you is a decision for your clinician and you.
What types of options are there for menopause symptoms?
The NHS groups the options for menopause and perimenopause under two main headings, hormonal and non-hormonal, and also mentions cognitive behavioral therapy among them (NHS, Treatment). Lifestyle changes are the foundation that goes alongside all of them.
Lifestyle changes
Among the steps that may help with symptoms, the NHS lists a regular sleep routine, regular exercise (especially weight-bearing movement that strengthens bones), a cool bedroom at night, and cutting down on spicy food, caffeine, hot drinks, smoking and alcohol; it adds that talking to people going through the same thing can also help (NHS, Things you can do). The Menopause Society also says low-risk lifestyle steps can help with hot flashes (The Menopause Society, Hot Flashes). On their own these will not remove every symptom, but they are the foundation for the other options too.
Hormonal options
Hormone therapy is a group of options based on replacing the hormones that are declining. The NHS says which type is discussed depends on whether you still have periods and whether you have had your uterus removed, and advises talking about it with a doctor, nurse or pharmacist (NHS, Treatment). Because benefits and risks vary from person to person, this option is always weighed together with your clinician, looking at your health history.
Non-hormonal prescription options
The NHS says there are non-hormonal prescription options for when hormonal options do not help enough with symptoms, are not suitable for someone, or the person does not want them. Some of these target hot flashes and night sweats; others target mood symptoms such as low mood or anxiety (NHS, Treatment). Which one is suitable is assessed by your clinician, taking into account the other medicines you use and your health.
Psychological support: cognitive behavioral therapy
Cognitive behavioral therapy (CBT) is a talking therapy with a set number of sessions that works with patterns of thinking and behavior. The NHS says CBT can help with low mood and anxiety, and can also make it easier to cope with hot flashes and sleep problems (NHS, Things you can do). The Menopause Society also lists CBT and clinical hypnosis among non-prescription options for hot flashes (The Menopause Society, Hot Flashes).
| Type of option | What it aims at | Who to talk to |
|---|---|---|
| Lifestyle changes | Reducing triggers; sleep, bones and overall health | Your family doctor (GP); your own symptom record |
| Hormonal options | Easing symptoms such as hot flashes and night sweats | A gynecologist or your family doctor |
| Non-hormonal prescription options | Hot flashes, night sweats or mood symptoms | Your clinician |
| Cognitive behavioral therapy | Coping with hot flashes, sleep, anxiety, low mood | A psychologist or mental health professional |
Who makes the decision about menopause treatment?
You and your clinician decide together. The NHS advises talking about the options with a doctor, nurse or pharmacist (NHS, Treatment). The Menopause Society also says the person and their clinician should weigh benefits and risks together based on the person’s health history, and that how severe the symptoms are, the person’s preferences and cost are also part of the decision (The Menopause Society, Hormone Therapy).
Your clinician usually looks at:
- Your age and how long it has been since menopause. The Menopause Society says being within the first 10 years after menopause or under age 60 is among the factors considered in the balance of benefit and risk.
- The type and severity of your symptoms. An occasional mild symptom and one that breaks up your sleep every night are not handled the same way.
- Your personal and family health history.
- Other medicines and supplements you use.
- Your preferences. No option is chosen against your wishes.
When does your clinician take a closer look?
With some health histories, hormonal options may not be suitable, or a more careful assessment is needed. The main situations the sources highlight are:
- History of breast cancer: The Menopause Society lists breast cancer risk among the main factors weighed in the benefit-risk assessment of hormone therapy. Hormonal options may not be suitable for people who have had breast cancer; your clinician assesses this.
- History of blood clots or clot risk: The Menopause Society says clot risk can vary depending on how the hormone is taken; for people who have had a clot or are at risk, which option is suitable is assessed by the clinician.
- History or risk of stroke: The Menopause Society says stroke risk is also part of the benefit-risk assessment (The Menopause Society, Hormone Therapy).
If one of these applies to you, it does not mean “you have no options.” Non-hormonal options, psychological support and lifestyle changes can still be discussed. That is why it matters to share your full health history at your appointment.
Common myths about menopause treatment
“Hormone therapy makes you gain weight.” The Menopause Society says hormone therapy is not associated with weight gain; it adds that weight gain in midlife is common and is linked to aging and hormone changes (The Menopause Society, Hormone Therapy). We explain why weight changes during this time in menopause weight gain.
“Custom-compounded hormones are more natural and safer.” The Menopause Society says hormones compounded for an individual are not safer or more effective than approved products and may not contain the amount prescribed (The Menopause Society, Hormone Therapy).
“Once you decide, it never changes.” The Menopause Society says whether the options are still needed should be reassessed from time to time, and that for most people hot flashes ease over time (The Menopause Society, Hot Flashes).
8 questions to ask your clinician at a menopause appointment
- Do my symptoms fit the menopause transition, or should another cause be looked into?
- Which types of options can be discussed in my situation?
- What are the possible benefits and risks of each, given my health history?
- Which conditions in my family or my own past affect this decision?
- Could there be an interaction with the medicines and supplements I use?
- Which changes to my daily routine could help with my symptoms?
- When and how will we judge whether an option is working?
- In what situations should I come back without waiting for my check-up?
Why bring a symptom record to your appointment?
When you talk through options with your clinician, the most valuable information is a true picture of your symptoms. Noting for a few weeks how many nights you wake up sweating, how many hot flashes you have a day, and how your sleep and mood are going makes it clearer what you are aiming for, and lets you see what has changed at the next check-up. You can find out how to keep a record in how to keep a symptom diary, and what else to bring to your appointment in before you see your doctor. We cover hot flashes themselves in detail on the hot flashes page.