There are several treatment options available to manage menopausal symptoms. These can be broadly categorized into two types: non-hormonal and hormonal therapies. Treatment options depend on the symptoms.

By far, Hormone replacement therapy (HRT) with estrogen is the most effective treatment for hot flashes, night sweats, to improve vaginal dryness and discomfort during sex, protect against bone loss and improve mood and cognitive symptoms associated with menopause including memory loss, difficulty concentrating and irritability. If you still have your uterus, it will be combined with progestin. HRT can be administered through pills, patches, creams, and vaginal rings. Speak with Dr. Patel about the benefits and risks of HRT and whether it is a good option for you. Dr. Patel will recommend the lowest dose and the shortest time needed to provide relief.

SCIENTIFIC UPDATE: More than twenty years ago a study was done to assess the benefits and risks of hormone replacement therapy in women in menopause. It found that women who took HRT with estrogen and progestin had an increased risk of breast cancer, heart attack, stroke and blood clots. An 18 year follow up reports that women who took hormone replacement therapy did not have a greater risk of dying. A new JAMA study reports that taking estrogen alone or with progestin for 5 to 7 years was not associated with risk of death from cardiovascular disease or cancer. Another study found that women who started HRT in early menopause tend to live longer than women who didn’t take HRT! Speak with Dr. Patel and she will explain this to you.

Treatments for hot flashes and night sweats

1. Hormone replacement therapy (HRT): HRT can be an effective treatment for hot flashes by replacing the hormones that decrease during menopause. However, HRT is not suitable for all women, and it can have potential risks and side effects. It is important to discuss the benefits and risks with your healthcare provider before starting HRT.
2. Antidepressant medications: There are several non-hormonal medications that can help relieve hot flashes, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs). These medications are typically used to treat depression or anxiety, but they can also help reduce the frequency and severity of hot flashes.
3. Gabapentin: Gabapentin is approved to treat seizures, but studies show it can reduce hot flashes
4. Clonidine: This drug is usually prescribed to treat high blood pressure, but studies suggest it may help relieve hot flashes.
5. Lifestyle changes: Certain lifestyle changes can also help reduce the frequency and severity of hot flashes, such as avoiding triggers like spicy foods, alcohol, and caffeine. Relaxation techniques such as yoga, meditation, or deep breathing exercises may also help to reduce stress, which can trigger hot flashes.
6. Natural remedies: Some natural remedies such as black cohosh, soy isoflavones, or evening primrose oil have been suggested to alleviate menopausal symptoms, including hot flashes. Speak with Dr. Patel about these options.

Treatments for sexual discomfort

1. Perform Kegels to strengthen the pelvic floor and improve urinary leakage.
2. Vaginal estrogen delivered in a cream, pill or ring can relieve dryness and discomfort along with other menopause symptoms. It can also rejuvenate atrophied tissues.
3. Regular vaginal sexual activity is important to stimulate blood flow and keep vaginal muscles toned.
4. Use a vaginal lubricant to reduce vaginal discomfort and dryness during sex.
5. Vaginal moisturizers are available over the counter and can improve and maintain vaginal secretions.

Treatments for mood changes

1. Relaxation techniques: Practicing relaxation techniques such as deep breathing, meditation, and yoga can help to reduce stress, improve mood and sleep quality.
2. Cognitive-behavioral therapy (CBT): CBT can help women cope with mood swings, anxiety, and depression associated with menopause.
3. Low-dose antidepressants: Low-dose antidepressants can help to reduce hot flashes and improve mood. They are most effective when combined with counseling or psychotherapy.
4. A healthy lifestyle: Including regular exercise, a healthy diet, good sleep hygiene and 7-8 hours of sleep and avoiding triggers such as caffeine, alcohol, and spicy foods are all wise steps to control menopausal symptoms.

Treatments for urinary incontinence

The symptom is a sudden urge to urinate with occasional leakage due to bladder weakness that begins in perimenopause.

1. Strategies to help improve these symptoms without medication include drinking enough water during the day and avoiding foods and drinks with high caffeine content or acidity that can irritate the lining of the bladder.
2. Perform Kegels to strengthen the pelvic floor and improve urinary leakage.

Treatments for bone loss

Bone loss accelerates significantly during late perimenopause and continues into menopause. Research reports that up to 20% of bone loss happens during perimenopause and menopause. On in two postmenopausal women will have osteoporosis and most will suffer a fracture during their lives which can substantially decrease quality of life and increase mortality. Hormone replacement therapy can help to prevent osteoporosis along with mood swings, vaginal dryness and night sweats.

Osteoporosis drugs may be recommended to prevent or treat osteoporosis. Dr. Patel may also recommend taking calcium supplements and Vitamin D supplements to strengthen bones.

Treatments for sleep difficulties

1. Hormone replacement therapy (HRT): HRT can help alleviate hot flashes and night sweats, which can improve sleep quality. However, as mentioned before, HRT is not suitable for all women, and it can have potential risks and side effects.
2. Lifestyle changes: Certain lifestyle changes can help improve sleep during menopause, such as avoiding caffeine and alcohol, exercising regularly, and establishing a regular sleep routine.
3. Cognitive-behavioral therapy (CBT): CBT is a type of therapy that can help women identify and change negative thought patterns and behaviors that may be affecting sleep quality. CBT can be particularly helpful for women who are experiencing anxiety or depression during menopause.
4. Medications: There are several medications that can help improve sleep during menopause, such as low-dose antidepressants, sleeping pills, or melatonin supplements. These medications should be used under the supervision of a healthcare provider, as they can have potential risks and side effects.

These are just a few suggestions for treating menopausal symptoms. It’s important to talk to with Dr. Patel so she can evaluate the risks and benefits of different treatment options and make a personalized treatment plan for you. Contact her at her Manhattan office to schedule a consultation to learn more about how to thrive in menopause.