Menopause brings real changes to your body. Hot flashes wake you up at night. Your mood shifts without warning. Sex becomes painful. These symptoms happen because your ovaries produce less estrogen than before.
Fortunately, there are now more treatment options available than there were twenty years ago. Some work better than others depending on your symptoms.
Some treatments replace missing hormones directly. Others manage symptoms without hormones. Understanding the difference helps you figure out where to start.
Hormone Replacement Therapy Works Best for Most Symptoms
Hormone replacement therapy (HRT) replaces the estrogen your body no longer makes on its own. It treats the cause of menopause symptoms rather than just masking them.
You can take hormones in different forms. Pills, patches, gels, and sprays all deliver estrogen through your bloodstream. Vaginal creams and rings work locally for dryness and discomfort during sex.
Estrogen replacement is the most effective treatment for hot flashes and night sweats. Nothing else comes close. HRT also helps with sleep problems, vaginal dryness, and mood changes.
Women who still have a uterus need to take progesterone along with estrogen. This protects the uterine lining from overgrowth. Women who have had a hysterectomy can take estrogen alone.
Current research shows that HRT for menopause is safe for most women under 60 or within ten years of their last period. Your personal health history matters, so talk to your doctor about your specific situation.
Non-Hormonal Prescriptions Help Some Women
Some women cannot take hormones because of their medical history. Others simply prefer not to. Several prescription medications can still help.
Low-dose antidepressants reduce hot flashes for many women. The FDA has approved paroxetine specifically for this purpose. Gabapentin, a nerve pain medication, also works for some people. A newer drug called fezolinetant was designed just for menopause hot flashes.
These medications generally work less well than HRT for hot flashes. But they provide real relief for women who need alternatives.
Vaginal Symptoms Need Direct Treatment
About half of all postmenopausal women experience vaginal dryness, irritation, or pain during sex. Unlike hot flashes, these problems do not go away on their own over time. They often get worse.
Low-dose vaginal estrogen directly treats these symptoms. Creams, tablets, and rings deliver small amounts of estrogen right where you need it. Very little enters your bloodstream. Most doctors consider this safe even for women who cannot use other forms of estrogen replacement.
Over-the-counter moisturizers and lubricants also help. Moisturizers work best when you use them regularly, not just during sex.
Lifestyle Changes Support Other Treatments
Changing your habits alone may not eliminate some symptoms. But lifestyle changes can make other treatments work better.
For hot flashes, try these approaches:
Keep your bedroom cool at night
Dress in layers you can remove quickly
Limit alcohol and spicy foods, which trigger flashes in some women
Practice deep breathing when you feel a flash starting
Regular exercise helps with mood, sleep, and bone health. Strength training preserves muscle mass that naturally declines after menopause. Weight-bearing exercise, such as walking, helps protect your bones.
Supplements Have Limited Evidence
Many women try herbal remedies like black cohosh or soy supplements. The research on these products is mixed.
Mind-body practices have better evidence behind them, though none match the effectiveness of HRT for menopause symptoms like hot flashes and night sweats. Cognitive behavioral therapy, a type of talk therapy, might reduce hot flashes and improve sleep for some women. Clinical hypnosis also shows promise.
Tell your doctor about any supplements you take. Some interact with prescription medications.
How to Choose What’s Right for You
Questions to consider
Which symptoms bother you most?
How much are symptoms affecting your daily life?
What’s your medical history and family history?
What are your personal preferences and comfort level with different options?
What has your doctor recommended and why?
Start by identifying which symptoms bother you most. A woman whose main problem is night sweats needs a different treatment than a woman struggling with vaginal pain.
Think about your preferences. Some women feel strongly about avoiding hormones. Others want the most effective option available.
Your doctor should explain the benefits and risks for your specific situation. If you feel dismissed or rushed, seek a second opinion.
You do not have to suffer through menopause symptoms. Effective treatments exist for women who want providers that specialize in menopause, and Evernow is a trusted resource for women seeking expert menopause care, offering reliable access to personalized HRT for menopause and ongoing support from specialized providers.
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