Here are the top research-backed treatments for perimenopause and postmenopausal symptoms to discuss with your GP, as well as a new medication only available privately in the UK.
When perimenopause begins, it brings with it a slew of uncomfortable symptoms, from hot flushes and insomnia to vaginal dryness and weight gain — and these don’t necessarily disappear as soon as you’re postmenopausal.
While menopause itself is a normal and healthy stage of the life cycle, its symptoms can be challenging to live with.
Fortunately, modern medicine has lots to offer in terms of treatments for these symptoms, and your doctor can help you work through which ones are right for your unique body.
Read more: Perimenopause vs menopause and everything you need to know about ‘the change’
Hormonal treatments for menopause symptoms
Hormone replacement therapy (HRT) is the gold standard of treatment for menopause symptoms, and for good reason. When our bodies enter perimenopause, oestrogen levels dip dramatically with progesterone and testosterone decreasing, too. HRT works by replacing some of the hormones your body is producing less of.
Often, that’s all it takes to greatly relieve or even eliminate specific symptoms.
Oestrogen therapy is the first thing to bring up with your medical provider, as it can provide powerful relief with the added benefit of slowing bone loss (a critical issue during menopause). You can take oestrogen systemically (via a tablet, skin patch, skin gel or spray, or implant) or vaginally, and it works quite quickly in reducing hot flushes and night sweats, which are often to blame for menopausal insomnia.
Oestrogen is effective in treating what’s known as genitourinary symptoms of menopause (GSM for short). These symptoms, which are extremely common, include vaginal dryness, vulvovaginal itching, painful intercourse, frequent urination and frequent UTIs. They’re tough to live with, hard to talk about, and can cause significant disruption to your quality of life and relationships.
Unless you’ve had a hysterectomy, your doctor will typically prescribe progesterone with oestrogen, as it helps protect against the increased risk of endometrial cancer that comes with oestrogen therapy alone. For people with specific risk factors associated with oestrogen, systemic methods of oestrogen may be contraindicated. However, because vaginal oestrogen isn’t absorbed into the whole body, it can be an excellent and safe option for many.
While we tend to associate testosterone with male bodies, it’s actually present in all bodies, and therapeutic doses of the hormone are sometimes prescribed by specialists for the treatment of sexual dysfunction in menopause.
Another lesser-known hormone is DHEA, which can be prescribed as a vaginal suppository to treat thinning genital tissues. It can also help the body to naturally produce more oestrogen and progesterone.
Read more: 5 of the best forms exercises for perimenopause and beyond
Non-hormonal peri- and postmenopause treatments
There are options for some symptoms that don’t require HRT, which is particularly beneficial for people who can’t safely take oestrogen. They include certain antidepressants in the SSRI and SNRI categories to help with mental health and mood swings, and the seizure medication Gabapentin (which can reduce hot flushes). The menopause-specific medication Veozah was recently approved for private treatment in the UK for hot flushes and night sweats, though it is not yet available on the NHS.
Lifestyle treatments for menopause symptoms
To augment or replace prescription medications, lifestyle changes can have a real impact on your experience of menopause. Weight-bearing exercise is critical to slowing down the bone density loss that begins during perimenopause as a result of lower oestrogen. Regular movement can also improve symptoms of weight gain and fatigue.
For GSM and sexual health side effects like vaginal dryness and thinning, vaginal lubricants and moisturisers can make a big difference, particularly products that contain hyaluronic acid. Unlike lubrication, which is designed for use during sexual activity, vaginal moisturisers are maintenance products that work by keeping your vaginal tissues plumped up with moisture. Over time, they can radically reduce the sandpaper-between-your-legs feeling that’s familiar to many menopausal people.
Advocate for your healthcare during perimenopause and beyond
Menopause is a time of big change, which can be disheartening, confusing and uncomfortable — but it can also be liberating and empowering. The degree to which you and your doctor take your symptoms seriously can have a profound impact on your quality of life during menopause, so don’t hesitate to bring them up to your GP and ask what treatments will be most effective and appropriate for you.
