Menopause is one of those inevitable milestones in life that at least half the world’s population will go through. For some, it creeps in quietly, bringing only mild changes. For others, it feels more like a rollercoaster ride of hot flashes, mood swings, and sleepless nights. Whatever your experience, the big question often becomes: ‘How do I manage these symptoms?’
The options usually fall into two broad categories: natural and medical interventions. Each has its strengths, and many find that the best approach is a mix of both. Here’s what you need to know to make an informed choice that’s best for you.
What actually happens during menopause
Menopause marks the end of your menstrual cycles, officially diagnosed after 12 consecutive months without a period. It typically occurs between ages 45 and 55, though some women experience it earlier or later.
During this time, oestrogen and progesterone levels drop, which can lead to symptoms like:
- Hot flashes and night sweats
- Mood changes or anxiety
- Vaginal dryness or discomfort
- Trouble sleeping
- Weight gain or slowed metabolism
- Changes in libido
Understanding that these shifts are rooted in hormone changes can help you make sense of your symptoms and decide how to address them.
Medical interventions: science-backed relief
For decades, medical treatments have been the go-to for managing menopause symptoms. While they’re not one-size-fits-all, they can be very effective, especially when symptoms interfere with daily life.
If you’re considering medical treatments, it’s worth consulting not only your doctor but also nurse practitioners or women’s health specialists. Many advanced practice nurses gain their expertise through an accelerated BSN programme, which prepares them to support women’s health at every stage, including menopause management.
Hormone replacement therapy (HRT)
Hormone replacement therapy, sometimes called menopausal hormone therapy (MHT), is one of the most common medical options. It replenishes the oestrogen (and sometimes progesterone) that your body stops producing, helping to reduce hot flashes, improve sleep, and maintain bone density.
There are several forms of HRT:
- Systemic HRT – pills, patches, gels: for full-body symptom relief
- Local oestrogen – creams, vaginal rings, tablets: for vaginal dryness and discomfort
While HRT can be very effective, it’s not suitable for everyone. If you have a history of breast cancer, blood clots, liver disease, or certain other conditions, you may need alternatives. Your healthcare provider can help you weigh the benefits and risks based on your medical history.
Non-hormonal prescription options
For those who can’t or prefer not to take hormones, other prescription medications can help.
- SSRIs and SNRIs – (also known as selective serotonin reuptake inhibitors and serotonin norepinephrine reuptake inhibitors, respectively). These are antidepressants like paroxetine or venlafaxine, which can reduce hot flashes and stabilise mood.
- Gabapentin – often used for nerve pain and can also ease night sweats.
- Clonidine – a blood-pressure medication that sometimes helps with hot flashes, though it’s not as commonly used today.
Your doctor can discuss which of these might be a good fit depending on your specific symptoms.
Vaginal and urinary treatments
If vaginal dryness, irritation, or urinary discomfort are your main concerns, local treatments may be all you need. Options include low-dose vaginal oestrogen, non-hormonal moisturisers, or newer treatments like ospemifene (a selective oestrogen receptor modulator that helps maintain vaginal tissue health).
Natural interventions: a whole-body approach
Some of those going through menopause prefer to explore natural or lifestyle-based approaches first, especially if their symptoms are moderate or they want to avoid medications. While evidence varies for different natural remedies, many can offer real relief, especially when paired with healthy habits.
Nutrition and supplements
A balanced diet can have a surprisingly big impact.
- Phytooestrogens – found in soy, flaxseed, and legumes. They act as weak oestrogens in the body and may help with hot flashes.
- Calcium and vitamin D – support bone health, which becomes especially important after menopause.
- Omega-3 fatty acids – obtained from fish, walnuts, or supplements. Improves mood and heart health.
There are some herbal supplements marketed as supporting menopause symptoms, such as black cohosh, red clover, or evening primrose oil. Research findings on these are mixed. Some studies show benefits, others don’t. Herbal supplements can interact with medications and perhaps lead to potential side effects, so always check with your doctor before adding them (or any other new remedies) to your routine.
Exercise and movement
Regular physical activity is one of the most effective ways to feel better during menopause. Exercise can:
- Reduce stress and anxiety
- Improve sleep quality
- Support heart and bone health
- Help maintain a healthy weight
Any form of movement is valid. Brisk walking, yoga, swimming, or strength training a few times a week can make a significant difference.
Mind-body practices
Mind-body techniques can help calm the nervous system, which may reduce the intensity of hot flashes and emotional ups and downs.
- Yoga and tai chi improve flexibility and lower stress.
- Meditation and deep-breathing exercises can help with irritability and sleep.
- Cognitive behavioural therapy (CBT) has been shown in studies to reduce the distress caused by hot flashes and improve mood and sleep.
Lifestyle adjustments
- Stay cool by dressing in layers and using fans or cooling pillows at night.
- Limit alcohol and caffeine, which can trigger hot flashes.
- Quit smoking, which not only increases health risks but also worsens menopause symptoms.
- Prioritise sleep by keeping a regular bedtime and minimising screen time before bed.
Who to talk to about your options
Menopause care is becoming more personalised, and thankfully, more widely discussed. Depending on your needs, you might talk to:
- Your primary care physician for general guidance and prescriptions.
- A gynaecologist who specialises in hormonal changes and reproductive health.
- An endocrinologist for complex hormonal issues.
- A menopause specialist for comprehensive care.
- A registered dietitian or nutritionist for dietary support.
- A therapist or counsellor can help if mood changes or sleep disruptions become overwhelming.
Don’t hesitate to bring up menopause at your next appointment, even if your provider doesn’t. You deserve support and up-to-date information.
Combining approaches: the best of both worlds
You don’t have to choose strictly between natural and medical interventions. Sometimes a combined approach works best. The goal is to feel like yourself again: balanced, comfortable, and in control.
To illustrate an example:
- You might use low-dose HRT for hot flashes while also practising yoga and mindfulness to manage stress.
- You could pair dietary adjustments and vitamin D supplements with local oestrogen therapy for bone and vaginal health.
- You may start with natural options, track your symptoms, and decide later whether to add medication if you need more relief.
Getting through menopause
Menopause is a major transition, and the right management plan can make these years far more comfortable and fulfilling.
Medical treatments like HRT offer proven, effective relief, while natural approaches like exercise and mindfulness can enhance overall wellbeing. Often, the most effective path is somewhere in the middle, tailored to your body, your symptoms, and your lifestyle. If you’re unsure where to start, talk to your healthcare provider about your symptoms, your health history, and your preferences. Together, you can create a plan that helps you thrive through menopause and beyond.
