What are my menopause treatment options? What you need to know to manage your symptoms
Search on the word “menopause” on the Internet, and where once there was mostly silence, crickets chirping, and the distant sound of an eagle’s cry, now there’s … a lot.
Menopause is having its day, and while that is very good and very overdue, it can be hard to wade through the chaos and separate good information on menopause treatments from rumor and hyperbole. We'll help you cut through the noise and understand the best menopause treatment options available to you.
Menopause Treatment Guidelines
Menopause is a natural and normal part of a woman’s life, I hear you say. Do we really need treatments for it?
Those lucky few who fly through menopause with nary a hot flash may not need any kind of external support. But many really suffer withmenopause vaginal issues, itching, sleepless nights, joint pains, annoying hot flashes, anxiety, brain fog, and a host of symptoms that range from disruptive to crippling.
Fortunately, there are treatments and behaviors that can help relieve menopause symptoms, so let’s talk about which menopause treatments work and which don’t, what’s safe and what isn’t.
How can menopause be treated?
At Gennev, we’ve found that menopause treatment follows three general tracks: medical intervention (hormone replacement, antidepressants, etc.), lifestyle and behavioral adaptations (diet, exercise, supplements, alternative therapies), or some combination of the two.
Every woman’s menopause journey is as unique as she is, so the best treatment for menopause for her will generally require a little experimentation and tweaking to get just the right formula.
Medical treatments for menopause
For many women, the safest and most effective menopause treatment is hormone replacement for hot flashes or HRT. While the poorly conducted Women’s Health Initiative trial appeared to indicate that HRT was not safe, the truth is that for most women, if taken correctly, HRT is safe and the best treatment for menopause symptoms.
HRT is the most universally effective treatment for hot flashes and vaginal dryness. In addition, it may provide protection against osteoporosis, heart disease, and even Alzheimer’s disease, so the long-term effects need to be brought in to the risk-benefit analysis.
HRT replaces what your body no longer makes enough of: estrogen. Estrogen does not appear to cause breast cancer (if it did, wouldn’t every woman have it?). However, since it appears to stimulate existant estrogen-sensitive breast cancer, it’s not recommended for women who’ve already had this type of cancer.
Birth control pills and hormonal IUDs help many women with symptoms of perimenopause and menopause. Again, birth control pills or a hormonal IUD like Mirena are not good options for women with a history of estrogen-sensitive cancers, but for many women, the steady release of estrogen can really help balance out hormones during the usually tumultuous perimenopause years.
Antidepressants in low doses can help relieve hot flashes and are generally safe for women regardless of breast cancer risk. The antidepressant dosage recommended for hot flashes is lower than the dose typically used to combat depression.
Moderate vaginal dryness, lichen sclerosus, and moderate incontinence can be successfully treated in many women with laser treatments like the Mona Lisa Touch. This is a good, non-hormonal treatment, but it hasn't been approved by the FDA (though it has been "cleared"). Be sure the practitioner is well-trained in its use and capabilities, and be aware that it is often not covered by insurance.
Bio-identical progesterone creams from a compounding pharmacy are tricky. These are unregulated, so we don’t recommend their use. Additionally, they are no more "natural" than the FDA-regulated medications.
Menopause medicine: over the counter treatments
Taking OTC medicines for menopause can be a bit concerning because lack of oversight from the FDA can mean some products can’t be safely verified. Taking ibuprofen for cramps or to reduce heavy bleeding, or fiber supplements for women's constipation is probably just fine; getting non-regulated bio-identical hormones from a compounding pharmacy or from the Internet may not be. If you’re going with hormones, please get a prescription from your GP or OB/GYN.
Over-the-counter medications are by nature less powerful than their by-prescription siblings, so you may not find complete or sustained relief. If you’re really suffering, there’s no reason not to get in touch with amenopause doctor near you and get a prescription.
If you have any concerns about your medication, OTC or other, check with your GP, OB/GYN or one of our menopause-specialist telemed doctors.
Natural menopause treatments that really work
First, it’s important to define “natural.” Some define it as “not from Big Pharma.” We understand why women prefer a more natural alternative, but (1) “natural” is not well-defined by any authoritative, regulating body like the FDA, and (2) “natural” does not mean “safe.” Death cap mushrooms are natural, but I wouldn’t want one in my salad.
There are natural remedies that appear to help women, but not enough studies have been done to verify their efficacy. Our approach is, if it doesn’t hurt, and it might be able to help, it’s worth a try. Check out our thoughts on natural remedies in our article “Hot flashes and alternative therapes: What really works?”
Soy (in food, not concentrated supplements, for hot flashes), black cohosh (for hot flashes), Omega 3 (for brain fog and fatigue), vitamin E (for hot flashes), and magnesium glycinate (joint pain, anxiety, and sleep) are all safe and reasonable things to try for menopause symptoms. And any supplement in the Gennev shop has been tested and made to rigorous standards.
Just remember, if you’re adding any concentrated substance to your diet (and this includes supplements, capsules, analgesics, etc.), please check with a doctor who knows your history and what medications you’re on, just to be sure there’s no concern about interactions.
Behaviors and menopause alternative treatments for symptoms
If you’re uncomfortable with hormones or unable to take them, you’re not out of luck. Behavior changes can take you a long way.
Most of these are things you know or can guess; the difficulty is in sticking with them long enough to see real results.
Hydration is so important and will help you more than you can imagine. Your body holds less water now, so dry skin, dry eyes, headaches, fatigue, and brain fog in menopause can all be helped by drinking more. Check out the book Quench by Dana Cohen, MD, if you need more encouragement to hydrate!
Exercise is critical.
Impact exercise like running and walking can help with bones. Building upper body strength can help with retaining muscle and increasing resting metabolism. Core strength can help with balance, meaning fewer falls. And all of these can help lift mood and invite better sleep.
Diet is another area where a few tweaks can make a significant difference. Now is when you need to increase lean protein and boost healthy greens. The Mediterranean diet is particularly beneficial for women with its emphasis on heart-healthy greens and grains and de-emphasis on red meats. Your brain will benefit, your bones will benefit, and as we age into higher risk of diabetes and heart disease, you’ll have a head start on avoiding long-term illness.
Sleep hygiene is a good idea for everyone, but it’s particularly helpful for peri- and post-menopausal women. Setting a bedtime routine, optimizing your bedroom for sleep, banishing screens two hours before bedtime, going to bed and getting up at the same time every day – you can start to train your body and mind to understand sleep signals so you can get better rest.
Stress reduction strategies
Don’t just say “yeah yeah” and wave vaguely at the piles of laundry, the bulging work email inbox, the kids, the dog, etc. Yes, life is busy and stressful. No, it’s not healthy, and you need to acknowledge when you need help and a lightening of the load. Taking time for self-care isn’t indulgent or decadent – it’s critical to good mental and physical health.
If you’re challenged or confused about any of these, or just need an accountability partner, we strongly suggest you sign up for Gennev’s Health Fix. You’ll get unlimited access to our Health Coaches, all of whom are Registered Dietitian Nutritionists and have had special training in menopause care.
There are menopause treatments that really work. It may take some adding, subtracting, tweaking, and testing, but most women find some combination of medical intervention, alternative treatments, and lifestyle change makes them feel a whole lot better.
To find out what route is truly the safest and most effective for you and the menopause symptoms you’re dealing with, talk with a menopause specialist physician. Team up with a Health Coach for ideas and accountability. What’s happening in your body may be frustrating, but it’s normal, and you’re not alone on this journey.
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