Managing menopause without hormones
Although hormone replacement may improve many menopausal symptoms, it is not safe for every woman. Hormone replacement therapy is usually not prescribed to women in the following categories:
- diagnosed with breast, or other hormone-sensitive cancers
- history of blood clots or clotting disorder
- age 60 or older
For women who cannot, or choose not to take hormone replacement, there are nonhormonal options for treating many menopause symptoms. Importantly, in some women, menopausal symptoms may decrease naturally over time. It is important to speak with your doctor and consider referral to a menopause expert to manage persistent symptoms.
Some of the more common menopausal side effects may respond to non-hormonal medications.
- Certain antidepressants, called selective serotonin reuptake inhibitors (SSRIs), may relieve hot flashes and other menopausal side effects. Brisdelle is an SSRI with Food and Drug Administration () approval for treating hot flashes.
- Limited research has shown that the drug oxybutynin—which is currently approved for treating overactive bladder—may reduce hotflashes.
Vaginal symptoms: Vaginal lubricants and moisturizers are widely available and do not require a prescription.
- Lubricants (e.g. K-Y, Astroglide, and others) can help make sex less uncomfortable.
- Vaginal moisturizers (e.g. K-Y Liquibeads, Replens, Hyalo GYN) are designed to be used on a regular basis (not related to sexual activity).
- Research has shown the antidepressant, bupropion (Wellbutrin) may improve satisfaction with sexual experience, arousal, and orgasm intensity. Larger studies are needed to confirm these findings.
Memory or mood changes:
- Research has shown some benefit from the medication Modafinil, a drug used to treat sleep disorders. Additional research is needed to confirm these findings.
Exercise may improve many of the side effects of menopause, including weight gain, sleep disturbances, memory and bone weakening. A type of pelvic muscle strength training known as Kegel exercises may help improve urinary incontinence. Additionally, exercise may help protect against heart disease.It's important to talk with your doctor before starting any exercise routine. Ask for a referral to a licensed physical therapist or exercise physiolgist to help you develop a safe and effective exercise routine.
It's important to check with your health care team before taking any supplements.
Vitamins and minerals are important to keep your body functioning properly. Experts recommend trying to get the nutrients needed through a balanced diet. However, in some cases, supplements may be needed. For example, some postmenopausal women may need calcium and vitamin D supplements in order to maintain their bone health.
Companies that make dietary supplements may market them specifically to post-menopausal women. It's important to be cautious of the claims made by these companies. Supplements have shown limited benefit in treating menopausal symptoms, and some supplements may actually be harmful. Because the does not regulate supplements, it cannot guarantee their safety.
- Mindfulness, meditation and training may improve member and thinking. Hypnosis, yoga, or acupuncture may relieve hot flashes and improve memory and sleep quality.
- Products such as handheld fans and "chillows" that reduce body temperature have been helpful for some women who experience hot flashes.
- Researchers are studying how well Carbon Dioxide (CO2) laser treatment such as MonaLisa Touch and radiofrequency treatment such as ThermiVa may help. These vaginal treatments do not have approval, and most insurance companies do not cover their costs.
The following resources can help you find experts who specialize in managing symptoms related to menopause:
- The North American Menopause Society has a tool to help you find a qualified menopause expert in your area.
- The National Certification Commission for Acupuncture and Oriental Medicine has a searchable directory of licensed acupuncturists.
- The American Academy of Sleep Medicine maintains the public-facing website SleepEducation.org that includes a section on finding a sleep center by location.
- The National Institutes of Health () and Related Bone Diseases National Resource Center has a page on finding an expert.
- Register for the FORCE Message Boards to get referrals from other members. Once you register, you can post on the Find a Specialist board to connect with other people who share your situation.
The following are studies on menopause and menopause management for survivors and previvors:
- NCT03815929: , Estrogen Therapy and Cardiovascular Disease Risk in Young Women. Researchers are trying to assess the best dose of estrogen for decreasing heart disease in women who have removed their ovaries before the age of 46.
- NCT05042362: A Study to Learn More About How Well Elinzanetant Works and How Safe it is for the Treatment of Hot Flashes Caused by Hormonal Changes Over 26 Weeks in Women Who Have Been Through the Menopause (OASIS-1). he study treatment, elinzanetant, was developed to treat symptoms caused by hormonal changes. Researchers will study how well 26 weeks of elinzanetant works compared to a in women who have been through the menopause and have hot flashes.
- NCT05099159: A Study to Learn More About How Well Elinzanetant Works and How Safe it is for the Treatment of Hot Flashes Caused by Hormonal Changes Over 26 Weeks in Women Who Have Been Through Menopause (OASIS-2). The study treatment, elinzanetant, was developed to treat symptoms caused by hormonal changes. Researchers will study how well 26 weeks of elinzanetant works compared to a in women who have been through the menopause and have hot flashes.
- NCT05030584: A Study to Learn More About How Well Elinzanetant Works and How Safe it is for the Treatment of Hot Flashes Caused by Hormonal Changes Over 52 Weeks in Women Who Have Been Through Menopause (OASIS-3). The study treatment, elinzanetant, was developed to treat symptoms caused by hormonal changes. Researchers will study how well 52 weeks of elinzanetant works compared to a in women who have been through the menopause and have hot flashes.
- NCT04251052: A Study to Compare Two Surgical Procedures in Women with Mutations to Assess Reduced Risk of Ovarian Cancer (SOROCk). Women with a mutation ages 35 – 50 at risk for ovarian cancer are eligible. SOROCk will determine if removal of alone can reduce the risk of ovarian cancer nearly as much as removing the ovaries and .
- NCT04439370: Autonomic Regulation of Blood Pressure in Premature and Early Menopausal Women. This study will look at the effects of early menopause on blood pressure.
- NCT03572153: A Mind-Body Intervention for Hot Flash Management. The main goal of this study is to test whether self-administered hypnosis can be used to reduce hot flashes more than self-administered white noise hypnosis over 6 weeks of home practice.
- NCT05086705: EMBr Wave for the Reduction of Hot Flashes in Women With a History of Breast Cancer. This trial studies how well a personal heating and cooling device worn on the wrist (called EMBr Wave) may help reduce hot flash severity in women with a history of breast cancer.
- NCT04821141: Phase IIB Trial of Bazedoxifene Plus Conjugated Estrogens. Women at increased risk for breast cancer experiencing hot flashes will receive bazedoxifene plus conjugated estrogens (similar to the drug Duavee) for 6 months or a control (no drug). Researchers will measure breast density on and needle biopsy looking at biomarkers.