“Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly…”.1

Umbrella
What may the Menopause Treatment Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Menopause Medications/Medicines/Therapies/Treatments
  • Menopause Symptom Medications/Medicines/Therapies/Treatments
  • Menopause Therapy Choices/Options
  • Menopause Treatment Choices/Options

Symptoms

How common are menopause symptoms?

On page one in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published online 10 June 2022, one of the recommendations is:

“The menopause transition can have a significant impact on many women, with more than 75% experiencing menopausal symptoms and a quarter describing their symptoms as severe. A third experience long-term symptoms, which may last as much as 7 years or longer”.2

Different Differences

Is menopause treatment one-size-fits-all?

In Menopause Management Options the (Australian) Jean Hailes for Women’s Health (JH) explain:

“Many women cope with mild menopausal symptoms and don’t need to take any medication or use therapies. Some women manage their symptoms with a healthy lifestyle, such as eating well and doing regular exercise. Other women with symptoms that affect their quality of life might choose to use medicines and therapies”.3

The JH also note:

Menopause Treatment“It’s important to seek accurate and reliable information before you start any treatment”.4

Treatments

What are some menopause treatments?

In Menopause: Diagnosis & Treatment – Treatment the (United States) Mayo Clinic elaborate on:

“Menopause requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and preventing or managing chronic conditions that may occur with aging. Treatments may include:

  • Hormone Therapy…
  • Vaginal Estrogen…
  • Low-Dose Antidepressants…
  • Gabapentin (Gralise, Horziant, Neurontin)…
  • Clonidine (Catapres, Kapvay)…
  • Medications to prevent or treat osteoporosis…”.5

Hormone Therapy

How effective is hormone therapy (HT) for the treatment of hot flashes and night sweats?

On page one in Deciding About Hormone Therapy Use: Potential Benefits the NAMS explain:

“Hormone therapy is one of the most effective treatments available for bothersome hot flashes and night sweats. If hot flashes and night sweats are disrupting your daily activities and sleep, HT may improve sleep and fatigue, mood, ability to concentrate, and overall quality of life. Treatment of bothersome hot flashes and night sweats is the principal reason women use HT. Hormone therapy also treats vaginal dryness and painful sex associated with menopause. Hormone therapy keeps your bones strong by preserving bone density and decreasing your risk of osteoporosis and fractures. If preserving bone density is your only concern, and you do not have bothersome hot flashes, other treatments may be recommended instead of HT”.6

Hormone Therapy Risks

What are the potential risks associated with HT?

On page one in Deciding About Hormone Therapy Use: Potential Risks the NAMS elaborate on:

“As with all medications, HT is associated with some potential risks. For healthy women with bothersome hot flashes aged younger than 60 years or within 10 years of menopause, the benefits of HT generally outweigh the risks. Hormone therapy might slightly increase your risk of stroke or blood clots in the legs or lungs (especially if taken in pill form). If started in women aged older than 65 years, HT might increase the risk of dementia. If you have a uterus and take estrogen with progestogen, there is no increased risk of cancer of the uterus. Hormone therapy (combined estrogen and progestogen) might slightly increase your risk of breast cancer if used for more than 4 to 5 years. Using estrogen alone (for women without a uterus) does not increase breast cancer risk at 7 years but may increase risk if used for a longer time”.7

Compounded Bioidentical Hormone Therapy

Is the use of compounded bioidentical hormone therapy recommended for the treatment of menopause symptoms?

On page two in The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement, published 07 July 2022, the NAMS note:

  • “Compounded bioidentical hormone therapy presents safety concerns, such as minimal government regulation and monitoring, overdosing or underdosing, presence of impurities or lack of sterility, lack of scientific efficacy and safety data, and lack of a label outlining risks”.8

On page four in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published 10 June 2022, one of the recommendations is:

  • “The use of compounded bioidentical hormone replacement therapies is not recommended given the issues related to their purity, potency and safety. The potential benefits of bioidentical hormone therapy can be achieved using conventionally licensed products available through NHS prescribing without having to resort to compounded varieties from specialist pharmacies”.9

Healthy Lifestyle

Can a healthy lifestyle improve menopause symptoms?

On page one in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published 10 June 2022, one of the recommendations is:

  • “Women should be advised that implementing or maintaining a healthy lifestyle can improve menopause symptoms. A healthy diet (one low in saturated fat and salt and rich in calcium and vitamin D), stopping smoking, reducing alcohol intake and including regular exercise can be beneficial. Reducing caffeine intake may also improve symptoms”.10

Complementary and Integrative Health

Can complementary and integrative health improve some menopause symptoms?

On page one in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause, first published 10 June 2022, one of the recommendations is:

  • “Alternative therapies, including cognitive behavioural therapy, may also improve hot flushes, nights sweats and other menopausal symptoms and can be considered in women who do not wish to take HRT or have contraindications to taking HRT”.11

In Menopause Management Options: Natural Therapies (Complementary Medicine and Therapies) the JH explain:

“The use of herbs in menopause is based on longstanding traditional use, some of which is supported by scientific evidence (e.g. a recent study into the effectiveness of red clover). But more research is needed regarding the effectiveness and safety of some herbal therapies for the management of menopausal symptoms”.12

Menopause Management Options: Natural Therapies (Complementary Medicine and Therapies) – Over-the-Counter Products the JH also note:

“The best way to seek guidance about these herbal remedies is to consult a health practitioner trained in herbal medicine use, such as a herbalist, naturopath or Chinese medicine practitioner”.13

Treatment Review

How often should menopause treatments be reviewed?

In the NICE Guideline Menopause: Diagnosis and Management – Information for the Public: Reviewing Your Care, the NICE [National Institute for Health and Care Excellence] elaborate on:

“You may be having different treatments or therapies to help your menopausal symptoms. To see whether treatment is helping you should be offered review appointments every 3 months to start with. If you are not having any problems you should then have appointments once a year. You should be offered an earlier review if you need it, for example if treatment no longer seems to be working or is causing side effects.

It is also important to keep going to all your routine health screening appointments (for example, breast and cervical screening)”.14

Health Care Provider

What if I would like help with menopause treatments?

If you would like help with menopause treatments, it may be in your best interest to choose to talk to your health care provider about this. The Mayo Clinic also encourage us to seek help:

“Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change”.15

The JH explain:

“Depending on your symptoms, you can also see a specialist. For example, a gynaecologist, psychologist, endocrinologist or dietitian”.16

Health Topics A-Z

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Links

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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Menopause: Diagnosis & Treatment – Treatment. 14 October 2020. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 08 December 2022
  2. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Optimising the Menopause Transition: Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022:1 https://journals.sagepub.com/doi/10.1177/20533691221104882 Accessed: 08 December 2022
  3. Menopause Management Options. Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 08 December 2022
  4. Menopause Management Options. Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 08 December 2022
  5. Menopause: Diagnosis & Treatment – Treatment. 14 October 2020. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 08 December 2022
  6. Deciding About Hormone Therapy Use: Potential Benefits. 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 08 December 2022
  7. Deciding About Hormone Therapy Use: Potential Risks. 2022:1. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 08 December 2022
  8. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement. 07 July 2022:2. North American Menopause Society https://www.menopause.org/docs/default-source/press-release/ht-position-statement-release.pdf Accessed: 08 December 2022
  9. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Optimising the Menopause Transition: Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published 10 June 2022:1 https://journals.sagepub.com/doi/10.1177/20533691221104882 Accessed: 08 December 2022
  10. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Optimising the Menopause Transition: Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published 10 June 2022:1 https://journals.sagepub.com/doi/10.1177/20533691221104882 Accessed: 08 December 2022
  11. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayasena, C. N., Briggs, P., Moger, S. Optimising the Menopause Transition: Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published 10 June 2022:1 https://journals.sagepub.com/doi/10.1177/20533691221104882 Accessed: 08 December 2022
  12. Menopause Management Options: Natural Therapies (Complementary Medicine and Therapies). Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 08 December 2022
  13. Menopause Management Options: Natural Therapies (Complementary Medicine and Therapies) – Over-the-Counter Products. Last Updated: 08 September 2022 | Last Reviewed: 19 August 2022. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 08 December 2022
  14. Menopause: Diagnosis and Management – Information for the Public: Reviewing Your Care. NICE Guidelines [NG23]. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/NG23/ifp/chapter/Reviewing-your-care Accessed: 08 December 2022
  15. Menopause: Diagnosis & Treatment – Treatment. 14 October 2020. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 08 December 2022
  16. Menopause: What Can You Do To Help With Menopause? Updated June 2022:2. Jean Hailes for Women’s Health https://jeanhailes.org.au/contents/documents/Resources/Fact_sheets/Menopause.pdf Accessed: 08 December 2022
Topic Last Updated: 08 December 2022  – Topic Last Reviewed: 08 December 2022

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