Treatment Options for Symptoms of Perimenopause and Menopause

Up to 85% of people going through menopause have symptoms like night sweats and hot flashes. These are also called vasomotor symptoms. But 70% go untreated. 

In the WebMD webinar “Moving Beyond Hot Flashes: Treatment Options for Symptoms of Perimenopause and Menopause,” Juliana M. Kling, MD, MPH, explained how hormonal and nonhormonal treatments can help you feel better during menopause.

“Hormone therapy is the most effective treatment for treating hot flashes and night sweats from menopause,” said Kling. “But for those of you who can’t take hormone therapy, we have a good toolkit of treatments that can improve your quality of life.”

Viewer Polls 

A poll during the webinar found that 42% of viewers wanted to know how a combination of nonhormonal treatments like hypnosis, cognitive behavioral therapy (CBT), antidepressants (SSRIs), and mindfulness-based stress reduction can help reduce menopause symptoms.

In another poll, 40% of respondents wanted to learn more about how hormone treatment for menopause can help improve sleep.

Question: I’m most interested in this nonhormonal treatment for menopausal symptoms:

  • Hypnosis: 4%
  • Cognitive behavioral therapy (CBT): 8%
  • Antidepressants (SSRIs): 14%
  • Mindfulness-based stress reduction: 30%
  • A combination of these: 42%

Question: I’m most interested in how hormone treatment for menopause can improve:

  • Sleep: 40%
  • Quality of life: 34%
  • Mood: 9%
  • Sexual function: 8%
  • Bone density: 6%

Viewer Questions

Kling answered some viewer questions during the webinar as well. These included:

Are there health problems for those who start menopause early?”

“Should you get annual OB/GYN exams, mammograms, or Pap smears after menopause?”

“Should you stay with your regular OB/GYN after menopause or change to a doctor who specializes in post-menopausal care?”

If you go through menopause before age 45, hormone replacement therapy may be a great option for you, said Kling. Early menopause can lead to a higher risk of long-term health consequences that include dementia, cardiovascular disease, decreased quality of life, osteoporosis, and sexual dysfunction.

After menopause, preventative care is still important. Kling suggests you see your OB/GYN on a regular basis, especially if you have vaginal dryness, bleeding, or breast lumps. 

She recommends that you have breast cancer screenings and mammograms annually or every other year until you’re at least 75. Pap smears with or without an HPV test (ask your doctor if you need one) are also important after menopause. If you’ve had a negative Pap test, also called a Pap smear, and a negative HPV test after the age of 30, then you can space these tests out every 5 years.

Kling says it’s up to you whether you want to stay with your regular doctor or switch to one who focuses on postmenopausal care. You can find a new doctor through the North American Menopause Society website.

“What’s a commonly misunderstood thing about menopause?”

“How long does hormone therapy last?”

“How long does it take after menopause to feel ‘normal’ again?”

Kling finds that a lot of people think hormone therapy is bad. Some think you should power through menopause symptoms without any treatment. But your symptoms can be very intense and affect your overall life. 

Hormone therapy is a safe and effective treatment, Kling said, if you’re under age 60 or within 10 years from your last menstrual cycle and don’t have any current or previous conditions that don’t allow you to use hormone therapy.

There’s no specific age cutoff for hormone therapy, she said. It depends on when you started menopause. Once you start, you may have symptoms for 7 to 10 years. So treatment will last as long as your doctor thinks you need it. You’ll decide with them, on an annual basis, if it makes sense for you to continue. You may only need it for a few years, but others may need treatment longer.

Since your symptoms can last up to a decade, it may take a while to feel “normal” again. But Kling said you may get back to feeling like yourself quicker through hormone therapy. 

“Does hormone therapy prevent or lead to weight gain?”

“Without any treatment for menopause, do symptoms like weight gain, mood swings, and other issues go away with time?”

Hormone therapy has little or no effect on how much you weigh, said Kling. But it can help with the way your weight may be distributed. For example, after menopause you may have more belly fat due to a drop in estrogen. But hormone therapy can help prevent that, she said.

While it doesn’t directly affect your weight, hormone therapy can help you stay energized and get better sleep at night. This may help you to get to the gym more often or eat healthier and avoid weight gain, according to Kling.

Without any treatment, your symptoms like night sweats or hot flashes will usually go away after menopause. But Kling said if you don’t get treatment, any weight gained during menopause may be harder to lose.

Nonhormonal Treatment Options for Menopause

Kling explained why treatment for vasomotor symptoms is so important. Studies show that those who go untreated visit their doctor more than those who get treatment. 

“We see that direct health care costs are higher for people with hot flashes and night sweats,” said Kling. “People with symptoms are also missing work, which directly impacts them and our society.”

But hormone therapy isn’t your only option. If you can’t or don’t want to use hormone therapy, these non-hormone options can help ease some of your symptoms:

Lifestyle approaches:

  • Cool clothing and environments
  • Staying away from triggers like caffeine or spicy foods
  • Regular exercise
  • Yoga
  • Weight loss


  • Paroxetine mesylate (Brisdelle)
  • Other SSRIs
  • SNRIs
  • Gabapentinoids
  • Clonidine (Catapres, Catapres-TTS-1, Catapres-TTS-2)

Mind-body techniques:

  • CBT
  • Clinical hypnosis
  • Mindfulness-based stress reduction
  • Pace respiration and relaxation

Complementary and alternative medicine (CAM):

  • Supplements and herbs like vitamin E, black cohosh, milk thistle, cannabinoids, and many more

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