Medication for menopause: You’ve got lots of options

Are menopause symptoms bothering you? Whether it’s hot flashes keeping you up at night, uncomfortable vaginal dryness, or mood changes, there are medications that can help. Here’s a look at some of the options. Let’s talk about medication for menopause, in case this is something you want to speak with your provider about.

Low-dose birth control

If you’re in perimenopause (the few years leading up to menopause), the hormones in a low-dose birth control pill may help manage hot flashes, vaginal dryness, and mood changes. Birth control can also help if your periods have become heavy or irregular. 

Hormone replacement therapy (HRT)

If you’ve reached menopause (it’s been at least one year since your last period), HRT is an effective way to ease menopause symptoms, including hot flashes, vaginal dryness, mood changes, and bone loss. If you have a uterus, your doctor will recommend a combination of estrogen and progesterone (progesterone helps protect you from uterine cancer). If you’ve had a hysterectomy, you may be prescribed HRT with just estrogen. 

HRT has been associated with some health risks, including blood clots, strokes, and some types of cancer. Studies show that risks are low for younger women (women in their 50s, or women who’ve experienced menopause even earlier). For added safety, experts recommend using the lowest dose of HRT that works for your symptoms, and limiting HRT use to a few years. Talk to your doctor about your health risks when you’re deciding whether to use HRT. 

While using HRT, be sure to keep up with your breast cancer screenings. Let your doctor know if you have unexpected bleeding while using HRT. 

Medications without hormones

Two main types of non-hormonal medications are FDA-approved to help manage the symptoms of menopause. Low-dose SSRI anti-depressants (lower than the dose used to treat depression) have been shown to help reduce hot flashes. Osphena™, a drug that behaves similarly to estrogen, can help if vaginal changes from menopause are causing you pain during sex.

These medications, developed for other conditions, have also been shown to help with hot flashes:

  • Gabapentin, an antiseizure and nerve pain medication
  • Clonidine, a blood pressure medication
  • Tamoxifen, a medication for treating breast cancer

Medications designed to help with vaginal dryness and pain during sex

If you’re experiencing vaginal changes, including dryness and painful intercourse, there are lots of treatments available:

  • Over-the-counter water-based lubricants can help with dryness and discomfort during sex. You can find lubricants next to condoms in most drug and grocery stores.
  • Over-the-counter vaginal moisturizers can be used regularly to help keep vaginal tissues moist, which can reduce general discomfort and pain during sex.
  • Prescription estrogen creams, tablets, and rings, can be put into the vagina to relieve dryness and pain. Prasterone, a daily vaginal insert, uses a different hormone to relieve vaginal symptoms.

Have questions about medications for the symptoms of menopause? Reach out to your provider if you have questions.

Reviewed by the Ovia Health Clinical Team


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