Things you can do
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Menopause
Contents
Lifestyle changes to help menopause and perimenopause
Eating well, exercising and looking after your mental wellbeing can help with symptoms during perimenopause and menopause.
It can also help you keep as well as possible in the future.
Do
- get plenty of rest, including keeping to regular sleep routines
- eat a healthy diet
- have calcium-rich food like milk, yoghurt and kale to keep bones healthy
- exercise regularly, try including weight-bearing activities where your feet and legs support your weight like walking, running or dancing
- do relaxing things like yoga, tai chi or meditation
- talk to other people going through the same thing, like family, friends or colleagues
- talk to a doctor before taking herbal supplements or complementary medicines
Don’t
- do not smoke
- do not drink more than the recommended alcohol limit
How to ease mood changes
It’s common to have mood swings, low mood and anxiety around the time of the menopause and perimenopause.
You can try to:
- get plenty of rest
- exercise regularly
- do relaxing activities
How to ease hot flushes and night sweats
You can:
- wear light clothing
- keep your bedroom cool at night
- take a cool shower, use a fan or have a cold drink
- try to reduce your stress level
- avoid or reduce potential triggers, such as spicy food, caffeine, hot drinks, smoking and alcohol
- exercise regularly
- lose weight if you’re overweight
CBT can also help manage hot flushes.
How to ease vaginal dryness
There are vaginal moisturisers or lubricants you can get without a prescription at a pharmacy.
You can talk to a pharmacist in private if you’d like help to decide which moisturiser is right for you.
If you’re having sex and using condoms, do not use oil-based lubricant as this can damage condoms. You can use a water-based lubricant.
There are other treatments for vaginal dryness that a doctor can prescribe, such as HRT (hormone replacement therapy) or hormonal treatment (creams, pessaries, gel or vaginal rings).
Find out about treatment for menopause.
Protecting against weak bones
You can try to:
- exercise regularly, including weight-bearing exercises, where your feet and legs support your weight (like walking, running or dancing) and resistance exercises (for example, using weights)
- eat a healthy diet that includes plenty of fruit, vegetables and sources of calcium, such as milk, yoghurt and kale
- get some sunlight on your skin as this triggers the production of vitamin D, which can help keep your bones healthy
- take vitamin D supplements
- stop smoking and cut down on alcohol
Read more about preventing osteoporosis.
Taking HRT can reduce the risk of osteoporosis.
Treatment for menopause and perimenopause
The main medicine treatment for menopause and perimenopause symptoms is hormone replacement therapy (HRT), which replaces the hormones that are at low levels.
There are other treatments if you cannot, or choose not to, have HRT.
Hormone replacement therapy (HRT)
HRT is a safe and effective treatment for most going through menopause and perimenopause. Your GP will discuss any risks with you.
HRT involves using oestrogen to replace your body’s own levels around the time of the menopause.
There are different types and doses of HRT. Using the right dose and type usually means your symptoms improve.
Oestrogen comes as:
- skin patches
- a gel or spray to put on the skin
- implants
- tablets
If you have a womb (uterus) you also need to take progesterone to protect your womb lining from the effects of oestrogen. Taking oestrogen and progesterone is called combined HRT.
Progesterone comes as:
- patches, as part of a combined patch with oestrogen
- IUS (intrauterine system, or coil)
- tablets
If you have low sex drive because of menopause and HRT does not improve it, you may be offered testosterone.
Benefits of HRT
The main benefit of HRT is that it can help relieve most menopause and perimenopause symptoms, including hot flushes, brain fog, joint pains, mood swings and 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.
Risks of HRT
The risks of HRT are small and usually outweighed by the benefits.
If you’re interested in HRT, your doctor or nurse can discuss the risks with you.
More information
Find out more about hormone replacement therapy (HRT).
Find out how to save money on HRT medicines with a prescription prepayment certificate.
Testosterone gel for reduced sex drive
If HRT does not help restore your sex drive, you might be offered a testosterone gel or cream. It can help improve sex drive, mood and energy levels.
Testosterone is produced by the ovaries and your levels usually get lower with age.
It’s not currently licenced for use in women, although it can be prescribed after the menopause by a specialist doctor if they think it might help restore your sex drive.
You can safely use this at the same time as HRT.
Side effects of using testosterone are not common but include acne and unwanted hair growth.
Testosterone gel or cream can also cause side effects in others if they come into contact with it regularly. To avoid this, wash your hands after using it and cover the area with clothing.
Read more about loss of libido.
Oestrogen for vaginal dryness and discomfort
Your vagina may become dry, painful or itchy as a result of the menopause and perimenopause.
A GP can prescribe oestrogen treatments you can insert into your vagina, as a tablet, cream or ring. This can also improve any urinary symptoms caused by menopause and perimenopause, like discomfort when you pee.
These vaginal oestrogen treatments do not get into your bloodstream and only work on the bit of the body where you put them. You can use them for the rest of your life. Symptoms usually come back when you stop using them.
It’s safe to use vaginal oestrogen with HRT.
Read more about vaginal dryness.
Non-hormone medicines
There are non-hormone treatments if your symptoms are having a big impact on your life and you cannot, or choose not to, have HRT.
Hot flushes and night sweats
There are some medicines that can help with hot flushes and night sweats.
These include:
- a blood pressure medicine called Clonidine
- an epilepsy medicine called Gabapentin
Talk with a GP about these medicines and their side effects, and if they might be suitable for you.
Mood symptoms
Antidepressants can help with mood symptoms if you’ve been diagnosed with depression or anxiety.
Cognitive behavioural therapy (CBT)
Cognitive behavioural therapy (CBT) is a talking therapy which can help with:
- low mood and anxiety caused by menopause and perimenopause
- some physical symptoms like hot flushes and joint pain
You can get NHS talking therapy without going to a GP first.
Find an NHS talking therapies service
Follow-up appointments
If you’re having treatment for your symptoms of menopause or perimenopause, you’ll need to return to the doctor or nurse who is prescribing your HRT for a follow-up review after 3 months.
When you and your doctor or nurse agree your treatment is working well for you, you’ll need to see them once a year.
During your reviews, your doctor or nurse may:
- make sure your symptoms are under control
- ask about any side effects and vaginal bleeding
- check your weight and blood pressure
- review the type of HRT you’re taking and make any necessary changes
You may need treatment for a few years, until most of your menopause and perimenopause symptoms have passed.
You can choose to continue taking HRT. The doctor or nurse prescribing your HRT can discuss with you the benefits and risks, so you can decide what’s right for you.
You can take HRT for as long as you need it. You can discuss this with your doctor or nurse at your yearly review.
Complementary and alternative therapies
Complementary and alternative treatments, such as herbal remedies and compounded bioidentical (“natural”) hormones, are not recommended for symptoms of the menopause or perimenopause.
This is because it’s not clear how safe and effective they are.
Red clover and black cohosh are herbal remedies but there is no strong evidence that they work.
Some complementary and alternative therapies can also interact with other medicines and cause side effects.
Ask your GP or pharmacist for advice if you’re thinking about using a complementary therapy.
Compounded bioidentical hormones
Compounded bioidentical hormones are sometimes offered in private clinics as HRT. They are not recommended because it’s not known how well they work or how safe they are. They are not available on the NHS.
They are different from regulated bioidentical hormones, also called body identical hormones.
Bioidentical hormones are available on the NHS as HRT. They have been tested to see how well they work and how safe they are.