Treatment and Prevention
Because each woman's experience with menopause is unique, treatment depends on the symptoms that are most bothersome.
Hot flashes
Hot flashes can be treated with prescription medications, alternative or herbal therapies, and lifestyle changes.
Prescription medications that may help with hot flashes include hormone therapy (estrogen with or without progestin) in pill, patch, or skin gel form; clonidine; and belladonna - ergotamine - phenobarbital.
Since hormone therapy has side effects and long-term risks, it's important for a woman and her doctor to weigh the benefits and the risks of using it.
Hormone therapy can be taken daily or in cycles. With cyclic therapy, hormones are taken on certain days of the month and women will have bleeding, similar to a light period, every month. With continuous or daily therapy, hormones are taken every day. There is no monthly bleeding, but women may have spotting (small amounts of irregular bleeding) during the first 3 to 6 months of continuous therapy. Talk to your doctor about which method would be best for you.
Women who have taken estrogen for more than 5 years may have a greater risk of developing breast cancer. An individual risk-benefit assessment and regular monitoring are required. In general, estrogen should not be taken if a woman has, or has ever had, breast cancer, advanced endometrial cancer, or abnormal vaginal bleeding.
The terms "natural" and "synthetic" are often used to describe the different types of estrogens and progestins. These terms can be misleading because they can be used to mean different things. Sometimes the term "natural" is used to describe the chemical structure of the hormone (exactly the same as the hormones normally produced by the human body), but other times it's used to describe where the hormone comes from (e.g., from plants or animals). What's most important is not whether the hormone is natural or synthetic, but whether you're receiving the medication, dose, and dosage form that are most appropriate for you.
Alternative and herbal medication, such as black cohosh, may also be an option. Speak to your doctor or pharmacist before trying them, especially if you have other medical conditions or are taking other medications.
Lifestyle changes that may help reduce the discomfort of hot flashes include:
- avoiding hot drinks or foods
- consuming cold drinks or foods
- dressing in layers
- exercising regularly
- learning relaxation techniques or controlled breathing
- losing weight if you're overweight
- sleeping in a cool, dark room
- using a fan or air conditioner
- wearing cotton or other natural fabrics
Vaginal dryness
When vaginal dryness or painful intercourse is the most bothersome symptom, prescription medications, non-prescription/alternative therapies, or lifestyle changes may offer some relief.
Medications that can help with vaginal dryness include vaginal estrogen tablets, vaginal estrogen rings, or vaginal estrogen creams. These medications supply estrogen directly to the vagina rather than through the bloodstream the way pills, patches, or skin gels do.
Non-prescription or alternative therapies for vaginal dryness include polycarbophil gel, lubricants, or vitamin E cream.
Lifestyle changes that can help with vaginal dryness include:
- decreasing stress in your life
- quitting smoking
- having sex or masturbating more often
- spending more time on foreplay
To prevent the bone loss that comes with menopause, women should reduce their alcohol consumption and cigarette use, and make sure to get enough calcium and vitamin D each day (1,500 mg of calcium and 800 units of vitamin D per day - note that your doctor may recommend a higher dose of vitamin D in some cases), through your diet and, if needed, supplements. Exercise and resistance training, also called weight training or strength training, helps prevent osteoporosis and control weight.
To maintain a healthy heart, quit smoking, maintain a healthy body weight, exercise regularly, and eat a healthy, balanced diet. Depending on your risk factors for heart disease, your doctor may recommend medications to reduce your risk, including medications to control your blood pressure or cholesterol.
Menopause is a normal stage in a woman's life. Natural menopause cannot be prevented.