Managing the menopause
There are various lifestyle and dietary measures that for some women, will help them manage their menopause symptoms. For those who need further treatment, options fall into 3 main categories:
Complementary or alternative therapies
For women who do not wish to use HRT or in who it is contraindicated there are some complementary or alternative therapies which may be of benefit. It is important however, to note that there is limited evidence for the efficacy and safety for most of the complementary therapies.
Non-hormonal treatment options
There are several non-hormonal medications for treatment of menopause symptoms available on prescription. These can be useful for women who are unable to take HRT. These are medications used for other reasons which have been found to improve hot flushes, for example some antidepressants (SSRIs/SNRIs), anti epileptics (gabapentin) and blood pressure medication (clonidine). Each of these has different risks, benefits and side effects and so choice will depend on your medical history and symptom profile.
Hormone Replacement Therapy (HRT)
HRT is the most effective treatment option for menopause symptoms. In addition, it will help reduce the risk of osteoporosis, heart diseases and dementia. HRT aims to replace the estrogen that your body is lacking after menopause. Women who have not had a hysterectomy will also need to take progesterone or a progestogen to protect the womb lining.
HRT comes in many different preparations for example estrogen can be taken via tablet, patch, gel, spray or implant. Each route had different pros and cons and it is important to find a preparation that suits you and fits in with your lifestyle.
We most frequently prescribe bioidentical HRT i.e. estradiol, progesterone and testosterone. This means they are biochemically similar to the molecule the body produces. They are plant products and tend to be derived from soy and yams. It is thought that these HRT formulations have lower risk than some of the older preparations used in the past. These products are all fully approved by drug regulators (MHRA) and are different to the compounded bioidentical treatments which are not regulated.
Many women will be concerned about taking HRT, however for the majority of women the benefits of HRT will outweigh any risks and there is no limitation on the length of time that women can use HRT.
We believe in an evidence based and holistic approach to care. During your consultation, we will go through the individualised risks and benefits of each treatment with you, to help you decide which option you prefer.