There are many ways to manage and treat menopausal symptoms, depending on your own unique experience. You might try different options before finding a treatment that works for you. It’s important to seek accurate and reliable information before you start any treatment.
Many women cope with mild menopausal symptoms and don't need to take any medication or use therapies. Some women manage their symptoms with a healthy lifestyle, such as eating well and doing regular exercise. Other women with symptoms that affect their quality of life might choose to use medicines and therapies.
Your doctor will consider your individual situation and explain different treatment options so you can make an informed decision. For example, they may discuss:
Menopausal hormone therapy (MHT)
Pharmacy-compounded hormones (bioidentical hormones)
Non-hormonal options
Related resources
Menopausal hormone therapy (MHT), formerly known as hormone replacement therapy (HRT), helps manage menopausal symptoms when they interfere with your life. Menopausal symptoms are caused by lowering levels of oestrogen hormones. MHT is the medical replacement of female hormones oestrogen and progesterone, and sometimes testosterone.
Oestrogen is the main hormone prescribed to relieve menopausal symptoms. If you’ve had a hysterectomy, this may be all you need.
If you haven’t had a hysterectomy, oestrogen and progesterone are used together, as progesterone reduces the risk of endometrial cancer (cancer of the uterus).
Other combinations of oestrogen and progestogen (including progesterone and other progesterone-like hormones) may also be recommended.
MHT replaces oestrogen to help control menopausal symptoms.
There are many ways to treat hot flushes and vaginal dryness, but no other treatment has been shown to be as effective as oestrogen replacement therapy.
MHT can be prescribed in different dosages and methods, depending on your needs and responses. For example, you might be prescribed pills, patches, gel, vaginal creams or an intrauterine device (IUD).
You may need to try different dosages or methods to find the right combination. Your doctor must supervise this process.
MHT can relieve common symptoms of menopause, such as:
MHT can reduce the risk of:
MHT can also improve:
Many studies have investigated whether MHT increases the risk of cancers, further illness and disease. The results of some studies led to a significant drop in the use of MHT.
A recent comprehensive review of evidence on MHT found it is an effective and safe treatment for the relief of menopausal symptoms for healthy women. The data showed that MHT had low risks for women aged between 50 and 60 years, but more research is needed to understand how MHT might affect other women’s health issues.
Research shows there are some risks associated with MHT. The risks of hormone therapy differ depending on:
It is not recommended you start MHT if you are older than 60 years or if you’ve been postmenopausal for 10 years or more.
Your doctor may advise you not to use MHT if it could increase your health risks.
For example, if you have:
Everyone responds differently to MHT. Some women may not experience any side effects, while others may have:
Most symptoms settle within the first three months.
You can take MHT at low doses for as long as you need. Many women have symptoms for around eight years and one in four women have symptoms into their 60s and 70s. The benefits of MHT far outweigh the risks in healthy women within 10 years of reaching menopause.
When using MHT in midlife:
It can take around six months to find the right MHT. Once you’ve found an MHT that works for you, it’s important to review it with your doctor each year.
If you have premature menopause, your doctor will prescribe a higher dose of MHT until the age of expected menopause (around 50–52 years).
In this podcast Jean Hailes endocrinologist Dr Rosie Worsley talks about menopause, including the benefits and risks of MHT.
Some doctors prescribe pharmacy-compounded hormones, which are also known as ‘bioidentical’ hormones. These are mixtures of different hormones made up in compounding pharmacies. The hormones are promoted as ‘natural’ and 'exactly like our own', which is not true.
Pharmacy-compounded preparations can contain oestrogens, progesterone and sometimes other hormones such as testosterone. The preparations are made into capsules, creams, gels, drops (applied to the tongue), lozenges or troches (soft square-shaped tablets) that are sucked inside the cheek.
All hormone therapies are manufactured synthetically. Hormones are only natural when they are in the human body.
Pharmacy-compounded hormones have no government controls or regulations and little or no high-quality research into their safety and effectiveness.
We do not recommend the use of pharmacy-compounded menopause hormone therapy.
Note: in Australia, doctors can prescribe conventional menopause hormone therapies (MHT) that are identical to those hormones made in your body. These products have been thoroughly tested for safety and effectiveness.
It’s important to have a face-to-face meeting with your health practitioner to discuss the risks and benefits of different treatments for menopause.
Some people can’t use menopausal hormone therapy (MHT), for example, if they've had hormone-positive (oestrogen-receptor-positive) breast cancer.
Some people don’t want to take MHT and prefer different treatment options, like non-hormonal prescription medications. These medications take around four weeks to be effective.
Some antidepressants have been shown to relieve hot flushes. For example, venlafaxine, paroxetine, escitalopram and fluoxetine. Side effects may include nausea, dry mouth, hot flushes, sweats and insomnia.
Note: Paroxetine and fluoxetine can reduce the effectiveness of some cancer treatment medications.
Gabapentin is a medication that prevents seizures and relieves pain for some conditions of the nervous system. It has also been shown to reduce hot flushes. Side effects may include a rash, dizziness and sleepiness, so it should be taken at night.
Clonidine is a medication for high blood pressure and migraines. It has been shown to reduce hot flushes. Side effects may include dry mouth, dizziness and drowsiness.
Get the most out of your medical appointments when discussing menopause and the years surrounding it.
Download our menopause fact sheets in English and in other languages.
This content has been reviewed by a group of medical subject matter experts, in accordance with Jean Hailes policy.
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