The main medical treatments for menopause symptoms include both nonhormonal and hormonal (hormone replacement therapy (HRT)) options. Treatment is usually individualized based on the types of symptoms being managed, personal and family medical history, age, and personal preference.
For vaginal symptoms, such as dryness, burning, and pain during intercourse, nonhormonal options like vaginal moisturizers and lubricants can be helpful for less severe symptoms. When symptoms are more severe, locally applied estrogen medications can be effective; however, local treatments will not improve other menopause symptoms like hot flashes.[1]
When systemic symptoms are present (e.g., hot flashes, night sweats, sleep disturbances, low mood), systemic HRT that provides estrogen, with or without progesterone, is the most effective option. This can be taken in a variety of ways (e.g., oral pill, skin patch or gel, vaginal ring), all of which carry their own risks and benefits. HRT may also reduce the risk of osteoporosis, type 2 diabetes, and colorectal cancer.[2][3][4] For people unable or unwilling to take HRT, non-hormonal options, like antidepressants, may also help to reduce hot flashes and improve mood.[5]
Despite the benefits of HRT, there are risks associated with this treatment, and it is not appropriate for everyone. For most women who start HRT within 10 years of menopause or before age 60, the benefits generally outweigh the risks.[5]
References
- ^The NAMS 2020 GSM Position Statement Editorial PanelThe 2020 genitourinary syndrome of menopause position statement of The North American Menopause SocietyMenopause.(2020 Sep)
- ^Barrionuevo P, Kapoor E, Asi N, Alahdab F, Mohammed K, Benkhadra K, Almasri J, Farah W, Sarigianni M, Muthusamy K, Al Nofal A, Haydour Q, Wang Z, Murad MHEfficacy of Pharmacological Therapies for the Prevention of Fractures in Postmenopausal Women: A Network Meta-Analysis.J Clin Endocrinol Metab.(2019-May-01)
- ^Cauley JA, Robbins J, Chen Z, Cummings SR, Jackson RD, LaCroix AZ, LeBoff M, Lewis CE, McGowan J, Neuner J, Pettinger M, Stefanick ML, Wactawski-Wende J, Watts NB,Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial.JAMA.(2003-Oct-01)
- ^Gartlehner G, Patel SV, Reddy S, Rains C, Schwimmer M, Kahwati LHormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Persons: Updated Evidence Report and Systematic Review for the US Preventive Services Task Force.JAMA.(2022-Nov-01)
- ^Nappi REThe 2022 hormone therapy position statement of The North American Menopause Society: no news is good news.Lancet Diabetes Endocrinol.(2022-Dec)