Treatments

Menopause is a natural change in life, so “treatment” during menopause actually involves treating not menopause itself but the symptoms of menopause and related health concerns. Staying healthy during and beyond menopause is also about more than just making it through this transition—considering that today’s average woman has more than one-third of her life ahead of her after menopause, this is a great time to take action to improve and protect your health.

Managing symptoms of menopause can begin with lifestyle changes designed to improve and maintain your general health; these include:

  • Don’t smoke or use any tobacco products. Avoid second-hand smoke. If you do smoke, you can benefit from quitting at any age.
  • Eat a healthy diet. Recommended food selections are low in fat, high in fiber, and include plenty of fruits and vegetables as well as whole-grain foods. You may need to cut back on calories as you age to control weight-gain, but be sure to eat plenty of nutrient-dense foods (foods loaded with protein and vitamins that are low in calories). Make sure you’re getting adequate amounts of vitamins and minerals from food sources or supplements. Calcium and vitamin D, for example, are important for bone health.
  • Maintain a healthy weight. Your doctor can help you determine a healthy weight, and a balanced diet and regular exercise can help you maintain it.
  • Stay active, including weight-bearing exercise. Protect your bone health with activities like walking, jogging, dancing, and lifting weights at least three days per week. Other types of physical activity (such as swimming, bicycling, and gardening) are also important, as they support overall health and help you maintain a healthy weight.
  • You can also directly address some of the symptoms of menopause and related health concerns by doing the following:

    • If your doctor has prescribed medications, make sure you take them as prescribed. Health problems around the time of menopause that can be treated with medication include high blood pressure, high cholesterol, and osteoporosis.
    • You can manage vaginal discomfort and dryness with a water-based lubricant or vaginal estrogen cream or tablet. Avoid petroleum jelly.
    • See your healthcare provider for regular breast and pelvic exams and Pap tests and mammograms. Report immediately to your doctor any changes to your body or health status, like a lump in your breast.
    • Get screened for colon and rectal cancer and skin cancer.
    • Keep track of your blood cholesterol levels, blood pressure, and blood sugar. Maintaining normal levels of all three can help protect your cardiovascular health.
    • Discuss urinary problems (such as infections and leakage) with your doctor. There may be ways to control these problems. Urinary incontinence is also treatable—bladder control training, medicines, implants, or surgery may help.

    There are several things you can do to manage hot flashes. Consider the following:

    • Determine what might be triggering hot flashes. Keep track of when hot flashes occur and in what circumstances. When possible, avoid situations that seem to trigger them.
    • Try to go to a cool place when a hot flash starts.
    • To manage night sweats, keep your bedroom cool. A fan may help.
    • Dress in layers. This way, you can remove clothing when you get too warm.
    • Use sheets and clothing made of fabrics that allow your skin to breath.
    • Drink something cold—like water or juice—when a hot flash is starting.
    • Some women find that medications, antidepressants in particular, help control hot flashes. Discuss these options with your doctor.

    Menopausal Hormonal Therapy

    There has been much debate surrounding the use of menopausal hormonal therapy (MHT) to relieve some of the symptoms of menopause and to prevent bone loss around the time of menopause.

    Though some women find that taking estrogen (and progesterone, among those who still have a uterus) does provide relief of symptoms like hot flashes, night sweats, and vaginal dryness, there are also risks associated with MHT. Studies have suggested that major health concerns associated with use of MHT include an increased risk of breast cancer and ovarian cancer and cardiovascular risks. Risk varies by type of MHT used (estrogen-plus-progestin versus estrogen alone). Talk with your doctor to determine what type of MHT might be right for you and about its risks and benefits. To minimize these risks, the U.S. Food and Drug administration (FDA) advises that if you choose to try MHT, you do so for the shortest time needed and use the lowest effective dose. Know that your symptoms may return when you stop taking the hormones.

    In addition to serious medical concerns associated with MHT, some women also experience additional side effects. These include breast tenderness, spotting or a return of monthly periods, cramping, and bloating. These side effects will sometimes go away on their own or may be alleviated by changing the dose or timing of MHT.

    Birth Control Pills

    Doctors sometimes recommend birth control pills during perimenopause. Birth control pills can help manage heavy, frequent, or unpredictable periods and can prevent pregnancy. As well, they may help relieve symptoms like hot flashes.

    Alternative Approaches

    Phytoestrogens. Some women look to non-medical methods to manage the symptoms of menopause. One approach is to increase dietary intake of phytoestrogens, which might work in the body like a weak form of estrogen. These estrogen-like substances are found in food sources including some cereals, vegetables, legumes (soy, for example), and herbs and can also be taken as an herbal supplement. The ability of phytoestrogens to relieve symptoms of menopause, however, has not been determined, and there may be risks associated with their use. It’s important that your talk to your doctor if you’re thinking about eating more foods rich in phytoestrogens or using a supplement.

    Bioidentical or “natural hormones.” Estrogen and progesterone can be made from plants such as soy or yams; these so-called natural hormones are supposed to closely resemble hormones naturally produced by the body. A doctor determines the formula for each patient, and a pharmacist puts it together in a process call compounding. There is little data about the safety or efficacy of natural hormones, as they are not regulated or approved by the FDA.

    Resources

    American College of Obstetricians and Gynecologists

    National Institutes of Health Menopausal Hormone Therapy Information

    North American Menopause Society

    National Institute on Aging Information Center

    Sources

    Women’s Reproductive Health: Menopause. Centers for Disease Control and Prevention Web site. http://www.cdc.gov/reproductivehealth/WomensRH/Menopause.htm. Accessed June, 2010.

    Age Page/Menopause. The National Institute on Aging Web site. http://www.nia.nih.gov/HealthInformation/Publications/menopause.htm. Accessed June, 2010.

    Menopause. The National Institutes of Health Web site. http://health.nih.gov/topic/Menopause. Accessed June, 2010.