Treating menopause symptoms

If you feel like you need help to manage your symptoms you can access support through your local GP practice. This will help you to make the decisions about your treatment that are best for you.

Sometimes, just knowing what to expect and how to manage specific menopausal symptoms can really help.

There are different ways to manage menopausal symptoms, including:

• eating a healthy, balanced diet and exercising regularly – maintaining a healthy weight and building more exercise into your daily routine can improve some menopausal symptoms
• cognitive behavioural therapy (CBT) – a type of talking therapy that can help with low mood and anxiety
• hormone replacement therapy (HRT) – tablets, skin patches, gels and implants that relieve menopausal symptoms by replacing oestrogen
• vaginal cream, tablet, pessary, gel or ring, lubricants or moisturisers for vaginal dryness

Your decisions about treatment may change as you journey through your menopause. If a treatment isn’t working for you, you can try something different. You can always seek a second opinion if you're not sure about the options offered to you.

Before speaking to someone you could try:

• taking notes of your menopausal symptoms and how or when they are affecting you
• preparing what you plan to discuss with a friend

Hot flushes and night sweats

We all wake naturally through the night. Ideally, we just roll over and go back to sleep. If you experience hot flushes and night sweats as a result of menopause, you are more likely to fully wake up and then struggle to get back to sleep. There are a few simple measures that may sometimes help, such as:

• keeping your bedroom cool at night – 16 to 18°C may seem cold but is ideal for sleeping (you can also keep your window and bedroom door open to let the air flow more easily)
• wearing loose, cotton pyjamas or night clothes can help you feel cooler than other materials (or try using cotton sheets and a light blanket in layers rather than a heavy duvet)
• wrapping an ice pack in a tea towel and slipping it under your sheets, like the opposite of a hot water bottle
• exercising regularly - regular weight-bearing activities such as walking, running and dancing have been shown to reduce symptoms of hot flushes, improve sleep and reduce the risk of osteoporosis
• taking a cool shower, using a fan or having a cold drink
• cut down on caffeine, alcohol and spicy food – as they have all been known to trigger hot flushes
• giving up smoking – if you smoke, giving up will help reduce hot flushes as well as your risk of developing serious health conditions, such as heart disease, stroke and cancer

If you find you are lying awake for a long time, get up and do something else (read a chapter of a book in another room, for example) for around 15 minutes, then try again. A distraction technique, once you are back in bed, can help avoid other thoughts coming into your head and keeping you awake for longer.

If the flushes and sweats are frequent or severe, or you feel like you need more help, speak to your local GP practice. They may suggest taking HRT.

If HRT isn't suitable for you, or you would prefer not to have it, your GP may recommend other medicines that can help.

Mood changes

Some women experience changes such as low mood and anxiety during the menopause.

Self-help measures to improve your mood may help, such as:

• getting plenty of sleep
• exercising regularly
• relaxing activities such as yoga and tai chi
• practicing mindfulness
• counselling

If you've been diagnosed with depression, medicine is also available, including HRT and antidepressants.

Other treatments such as cognitive behavioural therapy (CBT) can help with low mood and anxiety. CBT is a type of talking therapy and your GP may be able to refer you, or you can use our online mental health self-help guides.

Further information about menopause and your mental wellbeing

Vaginal dryness and discomfort

If your vagina becomes dry, painful or itchy as a result of the menopause, your GP can prescribe oestrogen treatment that's put directly into your vagina as a pessary, cream, gel or vaginal ring. This can safely be used alongside HRT.

The oestrogen cream will increase moisture and lubrication in the lining of your vagina and improve vaginal tissues making walking, exercise and penetrative sex more comfortable again.

Wearing cotton underwear and only washing your vagina with water will help to keep your vagina healthy.

You'll usually need to keep using vaginal oestrogen, as your symptoms are likely to return when treatment stops. However, side effects are very rare.

You can also use over-the-counter vaginal moisturisers or lubricants in addition to, or instead of, vaginal oestrogen.

Reduced sexual desire

All women experience menopause differently, many women experience changes in their sex life as they go through the menopause. You may have heard about menopause impacting women’s ‘libido’ or sexual desire.

There are lots of reasons why you might not want to have sex during menopause. This might include:

• vaginal dryness and discomfort that makes sex uncomfortable or painful
• reduced sex drive due to decreased hormones
• night sweats that affect your sleep and energy for sex
• emotional changes that can make you feel too stressed or upset for sex

As with all other symptoms of menopause it’s important that you seek advice when you need it as there is a lot that can be done to help. Don’t be afraid to speak to someone at your local GP practice as there are treatments that can help you get your sex life back on track.

Further information about sex, intimacy and the menopause

Hormone Replacement Therapy (HRT)

HRT replaces the hormones that are missing. Most symptoms are caused by low oestrogen levels, so this is the most important hormone to replace. If you have a womb you also need a progestogen to protect the lining of the womb.

HRT is extremely effective at relieving menopausal symptoms. It is available as tablets, skin patches, a gel or spray or, less often, implants.

In most cases, the benefits of taking HRT outweigh the risks. You may not be able to take HRT if you are undergoing certain types of cancer treatments or you may prefer not to take HRT.

Further information about HRT

Complimentary therapies

Some products are sold in health shops for treating menopausal symptoms. These herbal remedies include evening primrose oil, black cohosh, angelica and ginseng.

If you are thinking of trying herbal remedies, speak to your pharmacist or GP for advice. Natural doesn't always mean the treatment is safe or effective.

Further information about natural menopause relief