While menopause is inevitable, it's not a life stage we should be destined to dread. And that’s good news, especially because women spend more than one-third of their lives on average in menopause.
“In the past, menopause was looked upon with a negative light. The tides are turning, however, and many women now see menopause as a time for positive change,” says Lifeforce Physician Kimberly Hartzfeld, DO, OB-GYN. “Menopause can be the best time of your life. It can be very liberating for women. You can have sex without the worry of getting pregnant and you no longer have periods or PMS symptoms.”
The key to changing the narrative around menopause is managing your symptoms if they're starting to interfere with your quality of life. While the symptoms of menopause don't necessarily need to be medically treated, women with severe symptoms, such as intense hot flashes, depression, and frustratingly low energy levels, should speak to a doctor about treatment. And even if symptoms are mild, there are benefits to addressing hormone issues early. “As long as HRT is initiated within 10 years of menopause, it is associated with a reduced risk of cardiac events. Depending on the study, risk reduction of cardiac events is from 30-50%,” says Lifeforce Physician Dr. Susan Grabowski, DO.
These days, there are many effective research-backed menopause treatments available to help manage symptoms — so which treatments can help you feel like you again? Here's everything you need to know about the best menopause treatments available.
The 4 Top Treatments for Menopause Symptoms
1. Hormone Therapy
Menopausal hormone therapy (MHT), also known as postmenopausal hormone therapy and hormone replacement therapy, is the most effective treatment for menopause. As the name suggests, MHT replaces the hormones — estrogen and, sometimes, progesterone — that women see a decline in during menopause, per the National Institutes of Health (NIH).
Having lower levels of estrogen is the root cause of tell-tale menopause symptoms, such as hot flashes, vaginal dryness, and mood changes, and low estrogen levels are also associated with a higher risk of osteoporosis and heart disease.
“There has been more of a focus on hormone optimization in menopause over the past few years, not just for quality of life but also for disease prevention,” Dr. Hartzfeld says. "Hormone therapy started early in menopause can reduce the risk of cardiovascular disease, which is the number one killer of women. Both physicians and patients are realizing now that hormones are vital to health and well-being.”
In fact, just last week the WHI announced a long-term follow-up on their 2002 study that stated their initial reaction to hormone therapy drugs was largely overblown and that the benefits outweigh the short-term risk of menopause symptoms.
“We've done a disservice to women for the past 20-plus years by not providing the most effective, safe therapy for menopausal relief because of the overblown fear associated with hormone therapy,” says Lifeforce Medical Director Vinita Tandon, MD. “Prescriptions for hormone therapy fell by 85% after the results of the WHI were reported, creating panic and fear in women and their providers. It was an irresponsible misrepresentation of results that created such a bias against hormones that 20 years later, we're still struggling to reassure women and their providers about the safety and the unparalleled benefits that outweigh side effects and risk in most women who are recently menopausal."
MHT comes in different forms, including pills, creams, and skin patches, so you'll want to speak to your healthcare provider about the best option for you. Also good to know: Not everyone will be approved for hormone therapy — only women who have entered menopause recently and are at low risk for stroke, heart disease, blood clots, and breast cancer can be considered, per the NIH.
2. Low-Dose Antidepressants
Hot flashes, also called vasomotor symptoms, are the symptom most women going through menopause seek treatment for, according to Cedars-Sinai.
Currently, the U.S. Food and Drug Administration (FDA) has approved using paroxetine, an SSRI antidepressant, for the treatment of hot flashes. This antidepressant is the only non-hormonal treatment that's FDA-approved to treat hot flashes.
If you're using antidepressants to help relieve hot flashes, you generally won't take a dosage as high as someone taking antidepressants to manage depression. The recommended paroxetine dosage for hot flashes is 7.5 mg once daily at bedtime, while people taking the SSRI for depression will usually start at 20 milligrams per day, according to the Mayo Clinic. Side effects are dose-dependent, so if you're taking paroxetine for hot flashes, you're less likely to experience side effects from it than if you were taking it for depression.
3. Optimizing Your Diet
Drugs aren't your only course of action to treat persistent menopause symptoms. Changing your diet and prioritizing certain nutrients has been shown to help manage symptoms, too.
For example, including foods rich in phytoestrogens (or plant estrogens) has been shown to help reduce hot flashes as well as improve sleep, cognition, and bone health, per a 2012 review in The Journal of Steroid Biochemistry And Molecular Biology, but more research needs to be done to confirm these findings. Foods rich in phytoestrogens include soy products (tofu, edamame, natto, and soy milk), flaxseeds, sesame, beans, and dried fruits.
Getting more calcium and vitamin D can also help stave off bone loss. The NIH recommends getting at least 1,200 mg of calcium and 800 to 1,000 IUs of vitamin D every day. Calcium-rich foods include dairy products such as milk, cheese, and yogurt, as well as calcium-fortified foods such as cereals. There aren't many foods rich in vitamin D, so you're best off taking a quality D3 supplement.
Some studies suggest that taking supplements such as black cohosh and red clover might also help manage menopause symptoms, but the research on these natural alternatives isn't solid enough just yet. Research also shows that evening primrose oil may help reduce the severity, frequency, and duration of hot flashes.
If you do decide to start a new supplement, make sure to speak with your doctor first because certain supplements can interact with the medications you're on.
4. Exercising More
While hitting the gym or a HIIT class may not do wonders for banishing night sweats, exercising more can help stave off the long-term effects of menopause.
For example, exercising has been shown to improve postmenopausal women's triglyceride levels and lower their body fat, which are two risk factors of cardiovascular disease (and remember, cardiovascular disease risk increases once we hit menopause), per a 2020 Circulation study.
What's more, research shows that exercising regularly — specifically, strength or resistance training — can help improve bone density and stave off osteoporosis, another condition women are more likely to experience during and after menopause.
5. Reducing Stress
Some studies show that practicing mindfulness can help reduce the psychological symptoms of menopause, such as anxiety and depression, notes Dr. Hartzfeld. In a 2018 Scientific Reports study, peri- and postmenopausal women who practiced mindfulness saw significant improvements in their symptoms of depression and anxiety at the 8-month mark.
The main focus of the stress-relieving treatment in the study was empowering the participants to focus on awareness and accept the present moment, a key theme of mindfulness. The best thing about practicing mindfulness is that you can do it anywhere. Try a 20-minute meditation right when you wake up or before you go to bed, start incorporating mindful stretching exercises into your daily routine, or try a body scan meditation where you scan your body to pinpoint and relieve tension points. Working with a qualified therapist can also help you find out which stress-relieving techniques work best for you.
FAQ
Can hormone therapy relieve the symptoms of menopause?
Yes, menopausal hormone therapy (MHT) can relieve common menopause symptoms, such as hot flashes, vaginal dryness, and mood changes. MHT replaces the estrogen and, sometimes, progesterone that women see a decline in during menopause,
What is the best treatment for menopause?
Research has shown that MHT, or menopause hormone replacement therapy, is the most effective treatment for menopause.
Can the symptoms of menopause be treated?
Yes, menopause symptoms can be treated through hormone therapy or low-dose antidepressants, but natural alternatives such as diet modification, supplements, and exercise can also help treat symptoms.
Which medicines are the best for a menopause hot flush?
Menopausal hormone therapy and low-dose paroxetine (an antidepressant) can treat hot flashes. There's some evidence that evening primrose oil or rhapontic rhubarb may also help.
What is the best hormone therapy for menopause?
Menopausal hormone therapy usually consists of estrogen and progesterone since levels of both of these hormones drop during and after menopause.
To learn more about treating menopause symptoms, talk to your healthcare provider. You can also find a qualified clinician experienced in women’s hormone optimization through Lifeforce. Learn more HERE.
This article was medically reviewed by Kimberly Hartzfeld, DO, ABOG American Board of Obstetrics and Gynecology, IFMCP Institute for Functional Medicine Certified Practitioner.
Originally published on May 6, 2024. Updated on June 18, 2024.