Alternatives to HRT - Hormone replacement therapy (HRT)

If you cannot take HRT or decide not to, there are other ways to relieve your symptoms of menopause.

These include:

• lifestyle changes
• medicines
• herbal remedies

Lifestyle changes

Changing your lifestyle can help to reduce hot flushes, improve sleep, boost your mood and keep your bones strong.

You may want to try:

• regular physical activity
• eating a healthy diet
• cutting down on foods that trigger hot flushes, such as coffee, alcohol and spicy foods
• getting help to quit smoking
• reducing your stress levels
• getting plenty of rest

Wear loose clothes and sleep in a cool, well-ventilated room if you have hot flushes and night sweats.

Activities such as yoga and tai chi may help you relax.

Tips for reducing hot flushes

Things you can do to help symptoms

Vaginal lubricant

Try vaginal lubricant or moisturiser if you have vaginal dryness. There are several different types available to buy from shops and pharmacies.

Treatment for vaginal dryness

Medicines

Your GP may be able to prescribe you other medicines that help with menopause symptoms.

These include medicines that help with:

• hot flushes and night sweats
• bladder function
• sleep problems
• joint pains

Antidepressants

Some antidepressants can help with hot flushes and night sweats.

But they can also cause unpleasant side effects such as agitation and dizziness.

There are 2 types of antidepressants that can help with hot flushes caused by menopause:

• selective serotonin reuptake inhibitors (SSRIs)  
• serotonin-noradrenaline reuptake inhibitors (SNRIs)

But they are not licensed for this use.

This means they have not undergone clinical trials for use in treating hot flushes. But many experts believe they're likely to be effective. Your GP will discuss the possible benefits and risks with you.

Side effects of SSRIs and SNRIs

Side effects of SSRIs and SNRIs can include:

• feeling agitated, shaky or anxious
• feeling sick
• dizziness
• reduced sex drive

Side effects usually improve over time. Talk to your GP if they do not.

Herbal remedies

Several products are sold in health shops for treating the symptoms of menopause.

For example, herbal remedies like:

• evening primrose oil
• black cohosh
• angelica
• ginseng
• St John's Wort

Some of these remedies, including black cohosh and St John's Wort, may help reduce hot flushes.

St John’s Wort may affect your liver’s ability to break down and metabolise certain medications. Talk to your GP or pharmacist if you intend to take it with prescribed medication.

There's no scientific evidence that herbal remedies work.

Ask your GP or pharmacist for advice if you're thinking about using a herbal remedy.