Menopause and Non‑Hormonal Treatments: Effective Alternatives
Not everyone can—or wants to—use hormone replacement therapy (HRT) to manage menopause symptoms. Fortunately, there are well‑established non‑hormonal options ranging from lifestyle changes to prescription medications and newer therapies.
🌸 Why Consider Non‑Hormonal Treatment?
For women with contraindications to HRT—such as breast cancer history, thrombotic risk—or personal preference, non‑hormonal approaches can offer symptom relief with fewer hormone-related risks :contentReference[oaicite:1]{index=1}.
🏃 Lifestyle & Mind‑Body Strategies
- Weight management: Losing excess weight has been linked to fewer hot flushes :contentReference[oaicite:2]{index=2}.
- CBT & clinical hypnosis: These have proven effective in reducing hot flush frequency and intensity :contentReference[oaicite:3]{index=3}.
- Relaxation, paced breathing, exercise: Helpful as adjuncts, though evidence is mixed :contentReference[oaicite:4]{index=4}.
💊 Prescription Medications
Several medications originally for other conditions have shown effectiveness:
- SSRIs (e.g. paroxetine, fluoxetine, sertraline): Paroxetine is FDA-approved for hot flushes; others are also beneficial :contentReference[oaicite:5]{index=5}.
- SNRIs (venlafaxine, desvenlafaxine): Can cut flush frequency by ~50–65%, with efficacy close to low-dose oestrogen :contentReference[oaicite:6]{index=6}.
- Gabapentin and pregabalin: Anticonvulsants that reduce hot flushes in ~70% of women :contentReference[oaicite:7]{index=7}.
- Clonidine: A blood-pressure drug used off-label for flushes :contentReference[oaicite:8]{index=8}.
🆕 New & Emerging Therapies
- Fezolinetant: A neurokinin‑3 receptor antagonist recently approved by FDA and TGA—blocks brain pathways that trigger hot flushes and sweats :contentReference[oaicite:9]{index=9}.
- Stellate ganglion block: A nerve-block procedure under investigation for severe flush relief :contentReference[oaicite:10]{index=10}.
📝 How to Choose the Right Option
Your GP or menopause specialist can help decide, considering:
- Symptom severity and personal risks
- Medical history (e.g., cancer, heart issues)
- Side-effect tolerance (e.g., sexual function, blood pressure)
- Preference for medication vs. lifestyle vs. procedures
Decisions should align with the latest NAMS 2023 Position Statement on non‑hormonal therapies :contentReference[oaicite:11]{index=11}.
❓ Frequently Asked Questions
Are lifestyle changes enough?
They can help, but often aren’t enough alone for moderate-to-severe symptoms—CBT or medication may be added :contentReference[oaicite:12]{index=12}.
Is fezolinetant safe?
Early trials are promising, but long-term safety and availability are still under review. Discuss with your specialist :contentReference[oaicite:13]{index=13}.
Can antidepressants affect sexual health?
SSRIs/SNRIs can cause mild sexual side-effects, but at low doses used for flushes, these are often minimal :contentReference[oaicite:14]{index=14}.
🌟 Final Thoughts
Non‑hormonal treatments offer safe and effective menopause relief options without using oestrogen. Combining lifestyle changes, guided therapies, prescription meds, and emerging procedures can provide real relief—especially for those who can’t or prefer not to take HRT.
Work with your clinician to tailor a treatment plan that suits your symptoms, health background, and lifestyle. You don’t have to manage menopause alone—help is available, and relief is possible.