Not all women need treatment to relieve symptoms during perimenopause and menopause. But treatments are available if you find the symptoms particularly difficult.
There are also lifestyle changes and things you can do to help with your perimenopause and menopause symptoms.
The main medicine treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT).
There are other treatments available depending on what symptoms you have.
Hormone replacement therapy (HRT)
HRT balances your changing hormones around perimenopause and menopause. This can help with many of the symptoms.
HRT can help relieve most menopause and perimenopause symptoms, including:
- hot flushes
- brain fog
- joint pains
- mood swings
- vaginal dryness
Hot flushes or night sweats often improve within a few weeks. Other symptoms like mood changes and vaginal dryness can take a few months to improve.
Taking HRT can also reduce your risk of hormone-related health problems including osteoporosis and heart disease.
HRT is available as tablets, skin patches, a gel to rub into the skin, or a spray.
There are 2 main types of HRT: combined HRT and oestrogen-only HRT.
Combined HRT (oestrogen and progestogen)
This is for women with menopausal symptoms who still have their womb. Taking oestrogen on its own can increase your risk of womb cancer. But the progestogen will protect your womb.
Oestrogen-only HRT
This is for women who have had their womb removed in a hysterectomy.
Learn more about HRT
Other treatments
You can get other treatments for these symptoms:
Mood swings
If you have mood swings, antidepressants may help if you've been diagnosed with depression.
Cognitive behavioural therapy (CBT) is a type of talking therapy that can help with a low mood and feelings of anxiety.
Hot flushes
If the hot flushes and sweats are severe or happen very often, your GP may suggest taking HRT.
If you would prefer not to have HRT, your GP may recommend other medicines that can help. Discuss the risks and benefits with your GP before starting treatment.
CBT can also help manage hot flushes. It can also help with sleep problems.
Learn more about hot flushes
Reduced sexual desire
It's common for women to lose interest in sex around the time of menopause, but HRT can often help with this. If oestrogen and progestogen HRT is not effective, you might be offered a testosterone supplement.
Testosterone is a type of hormone in men and women. If you take it in small amounts it may help to restore your sex drive around menopause. It’s not currently licensed in Ireland for use in women, but it can be prescribed by a doctor if they think it might help.
Possible side effects of testosterone supplements include acne and unwanted hair growth. These are uncommon if your blood levels are kept within a certain range. You will get blood tests before and during treatment to check the levels.
Vaginal dryness and discomfort
If menopause causes your vagina to become dry, painful or itchy, your GP may prescribe oestrogen treatment. This can be used as a pessary, gel, or cream. You can also use this together with HRT.
These symptoms do not go away with time. They are likely to return when treatment stops. Because of this, you might need to keep using a vaginal oestrogen product long-term. Using this type of product long-term is safe as side effects are very rare.
You can also use vaginal moisturisers or lubricants you can get without a prescription at a pharmacy. Some women, where dryness is their main issue, may decide to use only vaginal oestrogen.
Learn more about vaginal dryness
Follow-up appointments
You'll need to return to your GP for a follow-up review of your treatment after 3 months, and once a year after that.
During your reviews, your GP may:
- make sure your symptoms are under control
- ask about any side effects and bleeding patterns
- check your weight and blood pressure
- review the type of HRT you're taking and make any changes needed
- discuss with you how to stop treatment if you decide you want to
Many women need treatment for a few years until most of their menopausal symptoms have passed.
Further treatment
Your GP may refer you to a specialist clinic if:
- treatment does not help your symptoms
- you have ongoing troublesome side effects after treatment
- you cannot have HRT
- you have a complex medical history
These specialist complex menopause clinics are in The National Maternity Hospital, The Rotunda Hospital, The Coombe Hospital, Cork University Maternity Hospital, University Hospital Galway and Nenagh General Hospital Women’s Health Hub.