Non-hormonal treatment options for menopausal symptoms
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Non-hormonal treatment options for menopausal symptoms130.06 KB
At menopause, changes in hormone levels can cause symptoms for many women – for example, hot flushes, mood and sleep changes. If your symptoms are bothering you, your doctor can help you to understand your symptoms and your treatment options.
Non-hormonal prescription medications are one of the treatment options available for managing symptoms. You might ask your doctor about these options because: you are not able to use menopausal hormone therapy (MHT) for medical reasons, you might not want to use MHT, lifestyle changes alone might not be enough if you have more severe symptoms. Your doctor can explain the best non-hormonal treatment options for your situation. Only your doctor can prescribe medications that can help with hot flushes, sweating and changes in sleep patterns and mood.
Fezolinetant
This is a treatment that blocks the nerve pathways in the hypothalamus that are involved in the production of hot flushes and sweats. It can reduce the frequency and severity of flushes.
Epilepsy treatments
Epilepsy drugs (gabapentin and pregabalin) have been used for many years to treat epilepsy and nerve pain and are safe and have few side effects. These medications can help with hot flushes and sweats in around 70% of women.
Antidepressants
Antidepressants (usually low dose) have been used for many years and some types help about 70% of women with more severe flushes and sweats. Options in this class of drugs include:
- venlafaxine (a Serotonin-Noradrenaline Reuptake Inhibitor or SNRI)
- escitalopram and paroxetine (Selective Serotonin Reuptake Inhibitors or SSRIs).
Paroxetine might decrease the effectiveness of tamoxifen, a medication sometimes used for women living with breast cancer. If this is an issue, ask your doctor about other options.
Emerging Treatments
Stellate Ganglion Block
This is a new potential treatment option involving a small injection of a local anaesthetic at the base of your neck.
This nerve block is not yet available in most clinics.
What are the other treatment options?
If your symptoms are bothering you, your doctor can help. Your doctor can tell you about the changes in your body and offer options for managing your symptoms. Other treatment options include:
- Lifestyle changes: Improving diet, regular exercise and stopping smoking improve overall wellbeing and can make symptoms easier to tolerate. Some psychological treatments e.g. cognitive behavioural therapy (CBT) and hypnosis may also help (See AMS fact sheet - Lifestyle and behavioural modifications for menopausal symptoms)
- Menopausal Hormone Therapy (MHT, formerly known as HRT): if other things do not work and you are able to have hormone treatment (See AMS fact sheets – What is Menopausal Hormone Therapy (MHT) and is it safe?)
- Complementary therapies: (See AMS fact sheet – Complementary medicine options for menopausal symptoms)
If you have any concerns or questions about options to manage your menopausal symptoms, visit your doctor or go to the Find an AMS Member service on the AMS website.
NOTE: Medical and scientific information provided and endorsed by the Australasian Menopause Society might not be relevant to a particular person's circumstances and should always be discussed with that person's own healthcare provider. This Information Sheet contains copyright or otherwise protected material. Reproduction of this Information Sheet by Australasian Menopause Society Members and other health professionals for clinical practice is permissible. No other reproduction or transmission is permitted in any form or by any information storage and retrieval systems except as permitted under the Copyright Act 1968 or with prior written permission from the copyright owner. ID:2025-02-27
Content updated February 2025