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Treatments and drugs
By Mayo Clinic staffMenopause itself requires no medical treatment. Instead, treatments focus on relieving your signs and symptoms and on preventing or lessening chronic conditions that may occur with aging. Treatments include:
- Hormone therapy. Estrogen therapy remains, by far, the most effective treatment option for relieving menopausal hot flashes. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose needed to provide symptom relief for you.
- Low-dose antidepressants. Venlafaxine (Effexor), an antidepressant related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs), has been shown to decrease menopausal hot flashes. Other SSRIs can be helpful, including fluoxetine (Prozac, Sarafem), paroxetine (Paxil, others), citalopram (Celexa) and sertraline (Zoloft).
- Gabapentin (Neurontin). This drug is approved to treat seizures, but it also has been shown to significantly reduce hot flashes.
- Clonidine (Catapres, others). Clonidine, a pill or patch typically used to treat high blood pressure, may significantly reduce the frequency of hot flashes, but unpleasant side effects are common.
- Bisphosphonates. Doctors may recommend these nonhormonal medications, which include alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva), to prevent or treat osteoporosis. These medications effectively reduce both bone loss and your risk of fractures and have replaced estrogen as the main treatment for osteoporosis in women.
- Selective estrogen receptor modulators (SERMs). SERMs are a group of drugs that includes raloxifene (Evista). Raloxifene mimics estrogen's beneficial effects on bone density in postmenopausal women, without some of the risks associated with estrogen.
- Vaginal estrogen. To relieve vaginal dryness, estrogen can be administered locally using a vaginal tablet, ring or cream. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissue. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms.
Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each.
References
- Bradshaw KD. Menopausal transition. In: Schorge JO, et al. Williams Gynecology. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=3158526. Accessed June 5, 2009.
- Manson JE, et al. The menopausal transition and postmenopausal hormone therapy. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.: McGraw-Hill Medical; 2008. http://www.accessmedicine.com/content.aspx?aid=2881945. Accessed June 5, 2009.
- Menopause. National Institute on Aging. http://www.nia.nih.gov/HealthInformation/Publications/menopause.htm. Accessed June 3, 2009.
- Cedars MI, et al. Menopause. In: Gibbs RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:725.
- Col NF, et al. In the clinic: Menopause. Annals of Internal Medicine. 2009;150:ITC4.
- Gass MLS. Menopause. In: Hillard PJA. The 5-Minute Obstetrics and Gynecology Consult. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:292.
- National Institutes of Health state-of-the-science conference statement: Management of menopause-related symptoms. Annals of Internal Medicine. 2005;142:1003.
- Cohen BE, et al. Feasibility and acceptability of restorative yoga for treatment of hot flushes: A pilot trial. Maturitas: The Europena Menopause Journal. 2007;56:198.
- Chattha R, et al. Treating the climacteric symptoms in Indian women with an integrated approach to yoga therapy: A randomized control study. Menopause: The Journal of the North American Menopause Society. 2008;15:862.
