If you experience menopause symptoms, they may go away without treatment. Or you may not find the symptoms uncomfortable. If you are bothered by your symptoms, talk to your health care provider. You can work together to find a treatment that is right for you. Some women may need medicine to help relieve their symptoms.

What medicines treat menopause symptoms?

If your menopause symptoms bother you, talk to your health care provider. They can suggest medicines to help with your symptoms. Treatment recommendations depend on a holistic evaluation by your health care provider and your choice of the options offered to you. All medicines have risks, and your health care provider can help you figure out which medicines are best for you.

• Low-dose hormonal birth control may help if you are in the years leading up to your final period, called perimenopause. These may help stop or reduce hot flashes, vaginal dryness, and mood swings. They can also help with heavy or irregular periods. You should not use hormonal birth control if you smoke. Hormonal birth control, especially combination birth control pills and possibly other forms of combination hormonal birth control like the vaginal ring or skin patch, can raise your risk for blood clots and high blood pressure, and the risk is higher for women who smoke.
• Menopausal hormone therapy can help treat menopause symptoms during perimenopause, menopause, and after menopause, but it can raise your risk for blood clots, stroke, and some cancers.
• Non-hormonal medicines are also approved by the Food and Drug Administration (FDA) and may help treat certain menopause symptoms. One low-dose selective serotonin reuptake inhibitor (SSRI) named fluoxetine, a type of medicine usually used to treat depression, is also approved to treat hot flashes in women who do not already have mood or anxiety problems. Another medicine called ospemifene acts like estrogen in the body is approved for the treatment of vaginal dryness and painful sex caused by menopause. A third medication named fezolinetant, influences the body’s temperature regulation system and is FDA-approved for the treatment of hot flashes. The FDA posted a warning about the possibility of rare but severe liver injury when using fezolinetant, so talk to your health care provider about the benefits and risks of these medicines.
• A hormonal medicine, named prasterone is approved by the FDA to treat women who experience pain during sex caused by vaginal dryness after menopause. This topical medicine is applied in the vagina once a day.
• Over-the-counter (OTC) products can treat vaginal discomfort, dryness, or pain. A water-based vaginal lubricant can help make sex more comfortable. A vaginal moisturizer can help keep needed moisture in vaginal tissues and make sex more comfortable.
• Certain prescription medicines may help with vaginal discomfort, dryness, or pain if OTC products don’t work. These include estrogen creams, tablets, or rings that you put in your vagina (see information on topical hormone therapy).
• Menopausal hormone therapy pill or patch may help if you have severe vaginal dryness.

What is menopausal hormone therapy?

Menopausal hormone therapy is prescription medicine that may help relieve your menopause symptoms, such as hot flashes and vaginal dryness, if they are severe enough to disrupt your daily life.

During perimenopause and menopause, your ovaries make very low levels of the hormones estrogen and progesterone. Menopausal hormone therapy replaces some of the hormones no longer made by your ovaries with artificial estrogen and progesterone.

Menopausal hormone therapy can help with hot flashes and other menopause symptoms. It is usually taken as a pill each day. You can also get estrogen or estrogen plus progesterone menopausal hormone therapy as a skin patch. Like all medicines, menopausal hormone therapy has risks. If you decide to take it, use the lowest dose for the shortest time needed. Another type of menopausal hormone therapy, called topical hormone therapy, does not treat hot flashes but can help with vaginal dryness. Learn more about these medicines at the FDA.

What is topical hormone therapy?

Topical hormone therapy is usually a low-dose estrogen cream applied directly to the vagina. It relieves vaginal dryness but does not help with other symptoms, such as hot flashes. It also is available as a vaginal ring, insert, and gel. The risks of topical hormone therapy are different from the risks of menopausal or hormone replacement therapy.

Is menopausal hormone therapy safe?

Menopausal hormone therapy (sometimes called hormone replacement therapy) is safe for some women, but like any medicine, it also has risks. That is why the FDA advises women who want to try menopausal hormone therapy to use the lowest dose that works for the shortest time needed. Current research shows that:

• Menopausal hormone therapy may be an option for women up to age 59, but usually only within 10 years of menopause. Younger women and those closer to their final menstrual period are less likely to have the harmful side effects from menopausal hormone therapy.
• Hot flashes usually require higher doses of estrogen therapy that affect the whole body.
• Women with vaginal dryness or discomfort during sex may find relief with low doses of topical vaginal estrogen.
• Estrogen alone and estrogen plus progesterone raise the risk of stroke and blood clots in the legs and lungs. The risks are rare in women between 50 and 59.

Who should not take menopausal hormone therapy?

Menopausal hormone therapy may not be safe for some women. You should discuss your risks with your health care provider if you have:

• A history of heart disease or risk factors, such as high cholesterol
• A family or personal history of breast cancer
• High levels of triglycerides, a type of fat in your blood
• A family history of gallbladder disease
• Liver disease
• A history of stroke or blood clots

How long should I take menopausal hormone therapy?

The FDA recommends that women take estrogen-only or estrogen plus progesterone menopausal hormone therapy at the lowest dose that works for the shortest time needed.

Talk to your health care provider to weigh the risks and benefits of menopausal hormone therapy based on your symptoms, age, and risk factors.

What is bioidentical hormone therapy?

Companies that make bioidentical hormone therapy use the term “bioidentical” to suggest that their products are exactly the same as natural hormones. Many of these companies also claim that their products are safer than menopausal hormone therapy. Many of these products are compounded drugs, which are not FDA-approved. FDA does not have evidence that compounded “bioidentical hormones” are safe and effective, or safer or more effective than FDA-approved hormone therapy.

FDA has approved drugs containing hormones that are identical to the hormones made naturally by women in their reproductive years.

Talk to your health care provider before trying any bioidentical hormone therapy.

What are some natural remedies for menopause symptoms?

Some women report relief for hot flashes and other symptoms with complementary or alternative therapies. Talk to your health care provider before taking any herbal or vitamin supplement. The FDA does not regulate supplements in the same way it regulates medicines. Many supplements can interfere with medicines and make them work incorrectly or not at all.

Some research studies show relief from premenstrual syndrome (PMS) symptoms with these herbal supplements, but other studies do not. Many herbal supplements should not be used with other medicines. Some herbal supplements women use for menopause symptoms are: black cohosh, red clover, soy, mind and body practices. Research continues on these and other alternative ways of relieving menopause. Talk to your health care provider before trying natural remedies.