Managing menopause

Almost all women experience symptoms at menopause. Most women find these symptoms manageable and choose not to have treatment. When symptoms are particularly severe or prolonged, there are a range of ways to manage them.​

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Hot flushes and night sweats

These are the symptoms most commonly associated with menopause.

You can reduce the impact of hot flushes if you can identify and avoid anything that may trigger them, for example, hot drinks, hot weather, stressful circumstances, spicy foods. Some women find it helpful to dress in layers to help them cool down more quickly. Some find a fan helpful. Stress reduction techniques such as mindfulness or meditation might also help ease this symptom.

Night sweats that disturb sleep are one of the most troublesome symptoms of menopause. Wearing light breathable bed clothes or sleeping naked might help ease this symptom. Some women use separate bed covers from their partners to avoid over-heating at night. A bedroom fan may also help.

Treatments for menopausal symptoms

Non-pharmacological (drug-free) treatments

There are several drug-free ways to reduce the impact of hot flushes and night sweats. These include:

• Counselling and psychological treatment such as cognitive behaviour therapy (CBT).
• Hypnosis may also be helpful.
• Some women also benefit from acupuncture.

Whilst paced breathing, exercise and relaxation programs (such as mindfulness) may be helpful for your general physical and emotional health, they do not significantly reduce menopausal symptoms.

Non-hormonal drug treatments

Several prescription medications have been shown to reduce hot flushes and night sweats. Unfortunately, these do not improve vaginal dryness. Prescription medications for hot flushes and sweats include:

• certain antidepressants (e.g. venlafaxine, escitalopram, citalopram, paroxetine)
• a drug called gabapentin (which is sometimes used to treat chronic pain)
• a blood pressure medication called clonidine.

These drugs may reduce hot flushes and nights sweats from around 40-60 per cent (when compared to a placebo or ‘sugar pill’ treatment). Using antidepressants and using treatments that improve sleep may also improve mood.

For more information see the fact sheet Treating hot flushes: An alternative to menopausal hormone therapy

Menopausal Hormone Therapy (MHT)

Menopausal hormone therapy (MHT) contains oestrogen to treat menopausal symptoms and may contain a progestogen to protect the lining of the uterus (womb) from cancer in women who have not had a hysterectomy. Menopausal hormone therapy is also known as hormone replacement therapy (HRT) or hormone therapy (HT).  

MHT reduces hot flushes and night sweats by around 80 per cent, making it the most effective treatment currently available. MHT also protects bone by reducing osteoporosis and fracture. Most women tolerate MHT very well, but some experience uterine bleeding or breast tenderness. These may need investigation by a gynaecologist to rule out other causes

Most healthy women around the age of natural menopause can safely take MHT for up to 5 years or at around age 60. Beyond 5 years there is an increased risk of breast cancer with combined (oestrogen plus progestogen) MHT. Stopping MHT may lead to a resurgence of menopausal symptoms.

See the fact sheet Menopausal Hormone Therapy for more information on:

• what symptoms it can treat and how
• how it is taken
• who can safely take MHT
• the benefits and health risk of MHT.

Compounded or bioidentical hormone therapy

These products are sometimes sold by pharmacists or over the internet. They may contain hormones but the dose and safety of the hormone content have not been checked in these products, therefore should be taken with caution.  For more information on compounded hormones visit Jean Hailes website.

Soy extracts and soy foods

Soy foods, foods enriched in isoflavones (plant-derived oestrogen-like substances such as red clover) and isoflavone supplements have not been consistently shown to reduce hot flushes. These compounds may have oestrogen-like effects, so discuss with your doctor whether they are safe for you. 

Herbal medicines

• Black cohosh - may have a mild benefit for hot flushes in some women.
• St John's wort - may improve depression but has not been shown to improve menopausal symptoms. St John’s wort may interact with other medications so check with your doctor before taking it.
• Evening primrose oil, dong quai, ginseng, licorice and sage do not reduce menopausal symptoms.

Unfortunately, no over the counter or herbal medicines have been shown to significantly reduce menopausal symptoms.

For advice

Talk to you doctor for more information and advice on treatment options.

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