Hormone Replacement Therapy (HRT)

Hormone Replacement Therapy (HRT) is a highly effective treatment for managing menopause symptoms, including hot flushes, night sweats, sleep disturbances, and vaginal dryness. By restoring hormonal balance, HRT can improve mood, cognitive function, and overall wellbeing during menopause.

There are two main types of HRT:
Estrogen-only therapy for women who have had a hysterectomy, and combined HRT for women who still have their uterus. Both types can be administered in various forms, including tablets, patches, gels, and creams.

Careful consideration of your health history and preferences will guide the choice of HRT, ensuring the best results with the lowest risk. Speak with your specialist about the appropriate HRT options for your needs.

Non-hormonal treatments

Not all women are suitable candidates for HRT, and many choose non-hormonal treatments for managing menopause symptoms. These options can also offer relief from symptoms like hot flushes, mood swings, and insomnia.

• SSRIs/SNRIs: Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) can help with hot flushes and mood changes.
• Gabapentin: Often used for nerve pain, gabapentin can also reduce hot flushes.
• Clonidine: An antihypertensive medication that may help reduce hot flushes and night sweats.
• Vaginal moisturisers and lubricants: Help alleviate vaginal dryness and discomfort during intercourse.
• Herbal remedies: Some women turn to natural treatments like black cohosh, soy isoflavones, and evening primrose oil for symptom relief, although efficacy varies and should be discussed with your healthcare provider.

Discuss these options with your menopause doctor to find the best treatment plan suited to your needs and lifestyle.

Alternative & Complementary Therapies

Many women explore complementary therapies to support their menopause care. These therapies may help reduce symptoms, improve mental clarity, and promote overall wellbeing during the transition to menopause and beyond.

• Acupuncture: May help relieve hot flushes, improve sleep, and reduce anxiety.
• Yoga and Meditation: Can support mental health, reduce stress, and promote physical flexibility.
• Massage therapy: Helps reduce muscle tension, improve sleep, and alleviate stress.
• Mindfulness and Cognitive Behavioural Therapy (CBT): Can be effective in managing mood swings, anxiety, and depression associated with menopause.

Many complementary therapies can be combined with medical treatments, but always ensure your healthcare provider is aware of any therapies you are using to avoid potential interactions or contraindications.

Vaginal Health & Genitourinary Treatments

Vaginal dryness, pain during sex, and urinary incontinence are common complaints during menopause. These symptoms are a result of decreasing estrogen levels and the associated thinning of vaginal tissues.

Treatment options include:

• Local vaginal oestrogen therapy: Topical creams, rings, or tablets that can restore moisture and elasticity to vaginal tissues.
• Ospemifene: A non-hormonal medication that may improve vaginal dryness and pain during intercourse.
• Pelvic floor exercises: Strengthening the pelvic muscles can help with urinary incontinence and improve sexual function.
• Vaginal lubricants and moisturisers: Available over-the-counter, these can help ease vaginal discomfort.

If you experience persistent or severe symptoms, your doctor can guide you toward the best treatment options for your needs.

Mental Health Support

Menopause can have a significant impact on mental health, including feelings of anxiety, depression, and mood swings. These changes are often due to hormonal fluctuations, but lifestyle, sleep disruptions, and the physical changes of menopause can also contribute.

Mental health treatments can include:

• Cognitive Behavioural Therapy (CBT): Effective in managing stress, anxiety, and depression.
• Antidepressants: SSRIs or SNRIs are often prescribed to help manage mood swings and hot flushes.
• Mindfulness & Relaxation Techniques: Yoga, meditation, and mindfulness practices can help manage stress and anxiety.

Addressing mental health as part of menopause care is essential for overall wellbeing. Speak to your doctor if you are struggling with anxiety or depression.

Long-term Health Management

Menopause care is about more than just managing short-term symptoms. Long-term health management is essential for reducing the risk of osteoporosis, heart disease, and cognitive decline.

• Bone health: Regular DEXA scans, calcium, vitamin D supplementation, and weight-bearing exercises help protect against osteoporosis.
• Heart health: Regular heart checks, a heart-healthy diet, and managing risk factors such as blood pressure and cholesterol.
• Cognitive health: Staying mentally active, maintaining a healthy lifestyle, and regular cognitive screening can support long-term brain health.

Long-term planning, including preventive care and lifestyle changes, is key to maintaining good health and reducing the risks associated with menopause and ageing.

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