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Sign Up for FORCE NewslettersManaging 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.
Medications
Some of the more common menopausal side effects may respond to non-hormonal medications.
Hot flashes:
- 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).
Libido:
- 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
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.
Supplements
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.
Other strategies
- 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 locate an expert near you or via telehealth.
Finding menopause experts
- The North American Menopause Society has a tool to help you find a qualified menopause expert in your area.
Related experts
Some symptoms of menopause may be managed by other experts. People experiencing menopause symptoms may benefit from a consultation with the following experts.
Sexual health experts
- The Sexual Medicine Society of North America has a search tool to find experts in your area who provide sexual health care services.
- The American Association of Sexuality Educators, Counselors and Therapists maintains a tool to help people find a sexual health expert near them.
Acupuncture experts
- The National Certification Commission for Acupuncture and Oriental Medicine has a searchable directory of licensed acupuncturists.
Sleep experts
- The American Academy of Sleep Medicine maintains the public-facing website SleepEducation.org which includes a section on finding a sleep center by location.
Bone density experts
- The Bone Health and Foundation has a searchable database for finding experts.
Other ways to find experts
- Register for the FORCE Message Boards and post on the Find a Specialist board to connect with other people who share your situation.
- National Cancer Institute (NCI)-designated comprehensive cancer centers have specialists to manage the symptoms and side effects of cancer prevention or treatment.
The following are studies on menopause and menopause management for survivors and previvors:
- 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.
- NCT04821141: Phase IIB Trial of Bazedoxifene Plus Conjugated Estrogens. Women at increased risk for breast cancer who experience 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 with and needle biopsy that looks at biomarkers.
- NCT06112756: A Study to Learn About How Elinzanetant Works and How Safe it is in Women Having Sleep Disturbances Associated with Menopause (NIRVANA). The study treatment Elinzanetant is being studied to treat symptoms like hot flashes which are caused by hormonal changes associated with menopause. It may block the activity of a protein that has been found to contribute to sleep disturbances.