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Information from Your Family Doctor
Treating Menopausal Symptoms
Am Fam Physician. 2010 Oct 1;82(7):809-810.
See related article on menopausal symptoms
What is menopause?
Menopause (MEN-oh-pawz) is when a woman's ovaries make less estrogen and other hormones. It is a normal part of aging. This usually starts around age 50, but can also happen earlier or later. It may take several years for menopause to occur because the ovaries may slowly make less hormones.
How do I know if menopause has started?
Your menstrual cycle (period) will become irregular and eventually stop. You may have hot flashes, which are hot or burning sensations that start suddenly and spread over your face and body. You may have a burning feeling in your vagina, or it may feel dry or irritated. This could cause pain during sex. Many women have these symptoms during menopause, but some do not.
How will my doctor diagnose it?
Most of the time your doctor can tell if you are in menopause based on your symptoms. A blood test is not usually needed.
Can hormone therapy help with my symptoms?
Hormone therapy works best for hot flashes. Many women can use hormones safely, but they may have side effects (like a higher risk of breast cancer and heart disease), especially if you use them for more than five years. Some women, including those with breast cancer, blood clots, or heart disease, should try nonhormone treatment first.
Many different types of hormone medicines are available. These include pills, skin creams or sprays, vaginal inserts, and patches. All of these are effective, so talk with your doctor to find out which one is the best option for you. Your doctor will want to see you regularly to talk about your treatment. In general, you should use the lowest dose possible for the shortest period of time. Also, if you still have your uterus (womb), you should take both estrogen and progesterone to prevent uterine cancer.
What else can I do to treat hot flashes?
Lifestyle changes can relieve hot flashes. Changes that may help include wearing loose clothing, using a fan, avoiding hot drinks, and using relaxation techniques such as meditation or slow breathing.
Some medicines, including some antidepressants and seizure medicines, can also help. These are not made from hormones, but you will need a prescription from your doctor. Every medicine has possible side effects, so you and your doctor should talk about which medicines are safe for you.
Are there any other medicines or supplements that can help?
Research shows that some herbal supplements are not very effective for treating menopausal symptoms. These include dong quai, Chinese herbal formulations, evening primrose oil, ginseng, red clover extract, kava, dietary soy, and black cohosh.
Compounded hormones (mixtures of certain hormones or supplements) have not been studied well. There is little information about whether these are safe. Because they contain hormones, they are likely to cause the same problems as other hormone preparations.
Bioidentical hormones are hormones similar to those your body makes. Your doctor can prescribe these. One example is estradiol (es-trah-DI-ol).
How can I treat vaginal dryness and painful sex?
An over-the-counter moisturizer called Replens, used inside your vagina three times a week, may help reduce dryness. Also, prescription hormone creams or vaginal inserts may help. During sex, many women find that a water-based lubricant helps reduce discomfort. Lubricants are available at almost every drug store without a prescription. Ask your doctor about your options.
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
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