Many women with menopausal symptoms will consult their GP for help and advice. These symptoms can be varied and include vasomotor symptoms (hot flushes and night sweats), urogenital dryness or irritation, muscle aches, poor sleep and low mood. For some women, explanation and reassurance may be all that is required; others may request treatment with hormone-replacement therapy (HRT). However, some women requesting treatment will not be able to take HRT, due to co-existing medical problems such as breast cancer or may wish to avoid hormones for other reasons. This article will describe some of the non-HRT treatments that may be offered either instead of or alongside systemic HRT.
BNF (2019) British National Formulary, London: BMJ Group and Pharmaceutical Press.
3.
Hickey M, Szabo RA and Hunter MS (2017) Non-hormonal treatments for menopausal symptoms. BMJ 359: j5101. DOI: 10.1136/bmj.j5101.
4.
Hunter M and Smith M (2014) Managing Hot Flushes and Night Sweats: A Cognitive Behavioural Self-Help Guide to the Menopause. East Sussex: Routledge.
5.
Lambert MNT, Thorup AC, Hansen ESS, et al. (2017) Combined red clover isoflavones and probiotics potently reduce menopausal vasomotor symptoms. PLoS ONE 12: e0176590. DOI: 10.1371/journal.pone.0176590.
6.
Leach MJ and Moore V (2012) Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database of Systematic Reviews 9: art. no.: CD007244. DOI: 10.1002/14651858.CD007244.pub2.
7.
LoprinziCLQinRBalcuevaEP, et al.(2010) Phase III, randomized, double-blind, placebo-controlled evaluation of pregabalin for alleviating hot flashes, N07C1. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology28(4): 641–647. DOI: 10.1200/JCO.2009.24.5647.
8.
MannESmithMJHellierJ, et al.(2012) Cognitive behavioural treatment for women who have menopausal symptoms after breast cancer treatment (MENOS 1): A randomised controlled trial. Lancet Oncology13(3): 309–318. DOI: 10.1016/S1470-2045(11)70364-3.
9.
NedrowAMillerJWalkerM, et al.(2006) Complementary and alternative therapies for the management of menopause-related symptoms: A systematic evidence review. JAMA Internal Medicine166(14): 1453–1465. DOI: 10.1001/archinte.166.14.1453.
10.
NICE (2015) Menopause: Diagnosis and management. Available at: www.nice.org.uk/guidance/ng23 (accessed 31 July 2019).
11.
NICE (2018) Early and locally advanced breast cancer: Diagnosis and management. Available at: www.nice.org.uk/guidance/ng101 (accessed 31 July 2019).
StubbsCMattinglyLCrawfordSA, et al.(2017) Do SSRIs and SNRIs reduce the frequency and/or severity of hot flashes in menopausal women. The Journal of the Oklahoma State Medical Association110(5): 272–274.
