Menopause occurs as levels of the hormones estrogen and progesterone decrease as you age. Some people can also go through menopause due to chemotherapy, surgical removal of the ovaries, or certain medical conditions.
Menopause typically begins between the ages of 45 and 55, when you’ve gone 12 consistent months without menstruation and can no longer get pregnant.
Everyone’s experience of the menopause transition is unique. Not everyone experiences symptoms — for those who do, the symptoms can differ in type, duration, and severity.
Hormone therapy is generally the most effective way to relieve many menopause symptoms. SERMs, lifestyle strategies, complementary medicine, and nonhormonal medications can also help.
Up to 85% of females who go through menopause experience symptoms. This can include:
- hot flashes
- vaginal dryness
- mood changes
- sleep disturbances
- weight gain
- muscle and joint pain
Different treatments like medications, alternative practices, and lifestyle strategies can help provide relief.
The exact treatment, including which medications to take, will be unique to you. It’s best you discuss it with a healthcare professional.
Language matters
Sex and gender exist on a spectrum. We use the term “women” in this article to reflect the term assigned at birth. However, gender is solely about how you identify yourself, independent of your physical body.
Hormone replacement therapy (HRT)
According to the British Menopause Society (BMS), hormone therapy is the most effective, first-line treatment for hot flashes and vaginal dryness.
HRT typically involves taking estrogen, alone or combined with progesterone. It works by replacing the hormones you are low in and that are causing you to experience menopause symptoms.
Side effects of HRT can include:
- bloating
- headaches
- leg cramps
- breast tenderness and swelling
Healthcare professionals usually recommend combined therapy for most people or estrogen-only therapy if you have undergone a hysterectomy.
Depending on your needs and preferences, there are various forms to deliver hormone therapy:
- patches or gels through the skin
- implants
- pills
Although the risk is low, the combined approach may be linked with a slightly increased risk of breast cancer, blood clots, and stroke. According to the BMS, the benefits of hormone treatment outweigh this risk for most people.
Vaginal estrogen
Vaginal estrogen is a form of hormone therapy.
Vaginal dryness, pain with intercourse, frequent urination, and frequent urinary tract infections (UTIs) are sometimes experienced by those going through menopause.
Some women find relief with local vaginal estrogen treatments such as:
- estrogen gels
- vaginal tablets
- vaginal rings
A 2016 review that included 44 studies notes that these treatments effectively provided relief for menopause symptoms with no or minimal side effects, regardless of the route of administration.
It’s important to know that estrogen treatments can increase your risk of endometrial and breast cancer. Consider speaking with a healthcare professional to determine which options may be best for you.
Bioidentical hormone replacement therapy (BHRT)
Bioidentical hormones are derived from plant sources and are identical to the chemicals produced by your body.
They include hormones such as estrogen, progesterone, and testosterone and can help with menopause symptoms, including:
- hot flashes
- night sweats
- mood changes
BHRT involves a saliva test that identifies and mimics the hormones in your body. It works by replacing the hormones you are low in, which are contributing to menopause symptoms.
It’s important to know that bioidentical hormones are custom compounded medications from Food and Drug Administration (FDA)-approved drugs. But the bioidentical hormones themselves are not FDA-approved. The American College of Obstetricians and Gynecologists recommends FDA-approved therapy over compounded hormone therapy.
Selective estrogen receptor modulators (SERMs)
Selective estrogen receptor modulators (SERMs) work by mimicking the effects of estrogen on certain tissues while blocking its effects on others. You typically take them orally in pill form.
Raloxifene (Evista) is a SERM used in the prevention and treatment of osteoporosis. It also reduces the risk of breast cancer after menopause has ended.
Another commonly used SERM is tamoxifen (Soltamox), which can prevent and treat breast cancer by limiting estrogen activity in the breast. It mimics estrogen in the uterus and can limit certain menopause symptoms.
It’s important to know that taking SERMs can carry risks, such as:
- uterine cancer
- breast cancer
- stroke
- blood clots
Consider speaking with a healthcare professional to identify your best option.
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