TREATMENT
TAKING CONTROL
You don’t have to put your life on hold with the menopause. Take control – you can do a lot to help yourself by making healthy choices around food and exercise +.
Regular help is available, too. Don’t be shy about speaking to your GP about your symptoms and asking if they’re related to menopause. Also, say if you would prefer to see a female rather than a male doctor. Ask if there is a GP with a special interest in women’s health at your surgery. This type of information is usually available on the surgery website, too.
Hot flushes, night sweats +, mood swings +, migraines + and other symptoms + of menopause can be hard to live with, both for you and for those around you such as partners, children and work colleagues. However, for you to be able to manage them, you need understanding from those around you.
Although menopause is rarely talked about, Rock My Menopause has been set up to break that taboo and get everyone talking openly about menopause at home, at work and in the community. We want to give you the confidence to discuss you menopause symptoms with your GP; there is no need for you to go through this alone. Check out how to get involved +
We are all unique in the way we experience menopause, so your GP should draw you up an individualised treatment plan. There are also qualified, private practitioners who can help, and many others who offer may offer alternative therapies +.
Vitamin and mineral supplements + and alternative + and mainstream therapies are other options that can assist you in managing your menopause symptoms +.
Remember, it’s important to get qualified medical advice around menopause treatments and, you’re in control, it is your body and they are your symptoms, if a treatment isn’t working for you, or you’d like a second opinion on the options available to you, have the confidence to speak up.
AVAILABLE TREATMENTS
What menopause treatments are currently available?
1. Diet and lifestyle changes +
DIET AND LIFESTYLE CHANGES
Making healthy food choices wherever possible, taking regular exercise, making time for yourself and getting enough sleep will also help you to manage your menopause symptoms.
- A healthy balanced ‘Mediterranean style’ diet based on fresh fish, vegetables and good fats such as olive oil, is good for general health.
- Spicy foods, alcohol, caffeine (tea and coffee as well as chocolate and cola drinks) can make hot flushes worse so avoiding these may help.
- Up your intake of vitamins B, C, D and E.
- Drink lots of water, this could be infused with fruit, or sugar free squash, anything which helps you to remain hydrated.
- Take up regular exercise that you enjoy. It needn’t be a chore to move your body, take a walk with a friend, join a class, try relaxing activities like yoga or Pilates. Regular exercise may improve hot flushes and night sweats, and improve sleep as well as helping you maintain or lose weight. Weight bearing exercise such as walking, running and dancing can improve bone strength.
- Take up meditation, breathing exercises or mindfulness.
- Get a good night’s sleep of seven to eight hours a night if you can, and if night sweats or insomnia keep you awake, speak to your doctor.
NATURAL MENOPAUSE RELIEF
‘Natural’ doesn’t always mean safe or effective, so do research these therapies thoroughly before using and seek advice from a qualified professional as some have potentially serious side effects or can interact with other medications. Herbal supplements are not regulated in the same way as prescribed medicines and may have differing levels of quality, dosage, effectiveness, and purity.
Herbal medicines can be registered under the Traditional Herbal Registration scheme in the UK and apply to use the THR Certification Mark with registered products. The Certification Mark provides a guarantee that the product meets certain defined standards. It shows that the Medicines and Healthcare products Regulatory Agency (MHRA) has assessed the product to ensure that is acceptably safe when used as intended, is manufactured to the quality standards set, and is accompanied by reliable and accurate product information for the public and patients.
If you are thinking of trying herbal remedies, speak to your pharmacist or GP for advice.
Herbal remedies around menopause
- Soy, which contains plant hormones with an oestrogen-like function. The British Dietetic Association state that consuming 50-80mg of soya isoflavones a day for 8- 12 weeks can lower hot flush frequency and severity by 25%.
- Black Cohosh is believed to help normalise the oestrogen/progesterone balance, improving sleep quality. However, evidence is not conclusive, and it does carry side effects.
- Red Clover is a source of natural plant oestrogens.
- Flaxseed may help to balance female hormones.
- Ginseng may help sleep problems.
- Some people say St John’s wort can help reduce hot flushes and night sweats and it is a well-known treatment for depression. However, the National Institute for Health and Care Excellence says that ingredients in St John’s wort products may vary, the effects may be uncertain, and they can interfere with other drugs, including those used to treat breast cancer.
- Some people use Evening Primrose oil although there is little evidence of its effectiveness.
- Some research has been conducted into the effects of sage in menopause.
- Bio-identical hormones duplicate naturally occurring hormones in the body, however, there is some controversy over these.
Some of these can cause significant risk, for example if you have a past history of breast cancer, particularly Red Clover and soy-based products. Black Cohosh has been associated with an increased risk of liver disease. There is evidence to show that St John’s Wort can help with mild anxiety and depression symptoms, but it interacts with many other medications and you should always tell your doctor if you are taking this.
HORMONE REPLACEMENT THERAPY (HRT)
Menopausal symptoms can be effectively treated with hormone replacement therapy (HRT), and in most cases the benefits of HRT outweigh the risks. However, there may be circumstances where you cannot take HRT, for example if you are undergoing treatment for certain cancers or you may prefer not to take HRT.
As the name suggests, hormone replacement therapy (HRT) replaces the hormones which decline in your body around the time of the menopause and perimenopause. It can relieve many of the symptoms that have an impact on quality of life at this time, in particular hot flushes and night sweats.
“Did you know?If you are fit and well and suffering menopausal symptoms, the benefits of HRT outweighs the risks until the age of 60.” – Dr Jane Davis
There are two main types of HRT
- Combined HRT (oestrogen and progestogen) – for women who still have their womb.
- Oestrogen-only HRT – for women who have had their womb removed in a hysterectomy.
HRT can be available as tablets, skin patches, a gel to rub into the skin, implants, or a form that can be placed inside the vagina. Side effects may include tender breasts, headaches, nausea, indigestion and vaginal bleeding – though this list is not exhaustive, side effects of specific forms of HRT will be included on the product information leaflet.
Although HRT went out of favour in the early 2000s because of a reported link with breast cancer, new guidelines from the National Institute for Health and Care Excellence (NICE) say that it is effective and should be offered to women with menopausal symptoms. However, your GP should discuss the risks and benefits with you first.
“Did you know? There is no longer an absolute age limit on when to stop HRT. A yearly review is recommended to ensure that for you, the benefits continue to outweigh the risks.” – Dr Jane Davis
HRT is not advisable for some women, such as those who have had certain types of breast cancer or are at high risk of getting breast cancer.
“Have you been told you can’t have HRT? There are plenty of prescribable alternatives to HRT available.” – Dr Jane Davis
See HRT in a Nutshell and our factsheet on Alternatives to HRT +
COMPLEMENTARY THERAPIES
Complementary therapies don’t fall within the traditional mainstream healthcare system. However, they may be used alongside conventional medical treatment to help you manage your symptoms. Here are a few examples:
- Cognitive Behavioural Therapy (CBT) can alleviate depression and anxiety as well as improve hot flushes and sweats. The National Institute for Health and Care Excellence recommends that people experiencing menopausal symptoms are given information about treatments such as CBT to help them manage certain symptoms.
- Research has been conducted into reflexology to improve sleep and hot flushes in menopausal women. Results are varied, however, one study conducted by researchers in Iran suggested that reflexology is an effective approach for sleep disorder and it also reduced frequency of hot flushes amongst some subjects.
- Research has proved that acupuncture can help menopausal symptoms, balancing hormones, reducing hot flushes, insomnia and anxiety.
- Massage can reduce stress, relieve menopausal symptoms and boost circulation of blood while promoting general relaxation.
See our factsheet on Alternatives to HRT + and read our section on Menopause and mental health +
ANTIDEPRESSANTS AND OTHER MEDICATIONS
There are a few other medications that your doctor can prescribe for your symptoms. These include antidepressants such as citalopram or venlafaxine which may help hot flushes. Medications such as clonidine and gabapentin have been tried and may also reduce hot flushes, but they have side effects of their own such as tiredness, weight gain and nausea.
The National Institute for Health and Care Excellence, which produces guidelines for healthcare professionals says that low mood is a common symptom of menopause and different from depression. Its guidelines on managing menopause symptoms say that: “If you’re feeling low as a result of menopause you may be offered HRT +. Another possible treatment is CBT (cognitive behavioural therapy) + and you may be offered this if you have low mood or anxiety as a result of menopause.
“Did you know? HRT can work better than antidepressants for women around menopause.” – Dr Jane Davis
“It has not been shown that antidepressant drugs called SSRIs and SNRIs can help with low mood during menopause if you haven’t been diagnosed with depression.”
Remember that not all symptoms will necessarily be linked to the menopause, so if you’re in any doubt, check with your GP and ask about the best course of action for you.
There are alternative lifestyle choices and medications which may help with menopausal symptoms but they are not necessarily safer or as effective as HRT. Discuss these alternatives with your doctor so that you can decide what is best for you.
