Treatment - Menopause

Not all women need treatment to relieve symptoms during perimenopause and menopause. But treatments are available if you find the symptoms particularly difficult.

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. It can also help to make lifestyle changes.

Hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) is a medicine-based treatment used to relieve symptoms of menopause and perimenopause.

You can get it for free under prescription from some pharmacies. You need a medical card or a Drugs Payment Scheme card if you do not already have one.

Read more about HRT

Other treatments

You can get other treatments for the following symptoms.

Mood swings

Talk to your GP if you experience low mood or depression.

Your GP may recommend cognitive behavioural therapy (CBT). This is a type of talking therapy that can help with a low mood and feelings of anxiety.

Hot flushes

Your GP may suggest taking HRT if you have hot flushes and sweats that are severe or happen very often.

If you would prefer not to have HRT, your GP may recommend other medicines that can help. Ask your GP about the risks and benefits before starting treatment.

CBT can also help you manage hot flushes and sleep problems.

Learn more about hot flushes

Reduced sexual desire

It's possible 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.

Possible side effects of testosterone supplements include acne and unwanted hair growth. These are less common 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 that 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:

• check 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
• give you advice on stopping treatment if you decide you want to

Many women need treatment for a few years until most of their menopausal symptoms have passed.

Further specialist treatment

Your GP may refer you to a specialist clinic if:

• treatment does not help your symptoms
• you have ongoing side effects after treatment
• you cannot have HRT
• you have a complex medical history

These clinics only see the most complex cases. They will assess your situation to see if they best suit your needs.

These specialist complex menopause clinics are in:

• The National Maternity Hospital
• The Rotunda Hospital
• The Coombe Hospital
• Cork University Maternity Hospital
• University Hospital Galway
• Nenagh General Hospital Women’s Health Hub