Menopause is a normal part of aging and every woman goes through it. It can't be prevented and normally doesn't require treatment. However, some symptoms of menopause can be lessened or perhaps even eliminated with treatment. Likewise, the risk of disorders or diseases associated with menopause, such as osteoporosis and heart disease, may benefit from treatment.
Physicians used to routinely prescribe hormone replacement therapy (HRT) with estrogen and, sometimes, progesterone to treat the general symptoms of menopause. However, this is no longer routine after several large studies showed that HRT can raise the risk of breast cancer, heart attacks, strokes, and blood clots.
If you are having trouble with menopause symptoms, talk to your health care provider about the benefits and risks of what is now called menopausal hormone therapy (MHT). According to the National Institute on Aging, only women at low risk for stroke, heart disease, blood clots, and breast cancer are considered candidates for MHT—and only those who have entered menopause recently. MHT can be given in the forms of pills, creams, or skin patches. Most medical professionals recommend an individualized MHT plan for each woman based on the age of menopause. It is important to know that MHT may cause side effects, such as bleeding, bloating, breast tenderness or enlargement, headaches, mood changes, and nausea.
The loss of estrogen may also be associated with changes in cholesterol levels and increased risk of heart disease. If you have high blood pressure or diabetes or are overweight, your health care provider may prescribe dietary changes or drugs to reduce your risk of heart disease, heart attack, and stroke.
There are a variety of options available to help treat the symptoms of menopause. The National Institute on Aging provides detailed information on some treatments for menopause. In addition, the Department of Health and Human Service's Office on Women's Health also provides information about menopause treatments. The sections below provide some additional information.
Treatment for Osteoporosis and Bone Loss Related to Menopause
Because bone loss increases in the first two years after menopause, health care providers may order a bone density test, such as a dual-energy X-ray absorptiometry (DEXA) scan. If you have osteoporosis or are at risk for it, your health care provider may prescribe bone-strengthening drugs or supplements to help prevent future bone loss and fractures.
Medications commonly prescribed to treat osteoporosis include:
- Bisphosphonates
- Calcium + vitamin D
- Calcitonin
- Parathyroid hormone
- Raloxifene
There are also many things you can do as part of a healthy lifestyle to help prevent bone loss:
- Eat a healthy, low-fat, low-cholesterol diet that features lots of vegetables, fruits, and whole-grain foods.
- Make sure to get at least 1,200 mg of calcium and 800–1,000 international units (IUs) of vitamin D each day.
- Avoid drinking more than one alcoholic drink per day.
- Don't smoke.
- Avoid consuming caffeine.
- Achieve and maintain a healthy weight.
- Exercise most days of the week, including exercise that elevates your heart rate, and weight-bearing exercises such as weight lifting or walking.
Treatment of Hot Flashes and Night Sweats
Several prescription drugs are available to relieve hot flashes and night sweats:
- Clonidine, a blood pressure drug
- Gabapentin, a seizure drug that has been shown to reduce hot flashes
- Menopausal hormone therapy (MHT)
There are also several practical things you can do on a daily basis to relieve these symptoms:
- Sleep in a cool room in light clothing.
- Keep a fan on in your bedroom at night.
- Sip a cold drink of water or juice.
- Avoid smoking, caffeine, and alcohol.
- When you feel a hot flash coming on, take several slow, deep breaths.
Treatment of Irregular or Missed Periods
While irregular or missed periods are normal during perimenopause or the menopausal transition, women with very heavy bleeding or periods close together may want to talk to a health care provider about regulating their periods with one of the following:
- Low-dose birth control pills to regulate menstrual bleeding
- MHT
Treatment of Vaginal Dryness
- A water-based lubricant (not petroleum jelly)
- MHT
Treatment of Sleep Problems
- Be physically active most days of the week during the day.
- Go to bed and get up at the same time each day.
- Set aside time to wind down and relax before bed, whether by reading or taking a warm bath.
- Avoid alcohol or eating a large meal right before bedtime.
- Avoid caffeine after the morning.
- Avoid drinking fluids before bed.