How to Treat Menopause Symptoms without Hormones

Learn what your non-hormonal options are when treating your menopausal symptoms.

Sanaz Majd, MD,
June 1, 2011

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4.  Hot flashes:  I’ll be honest and tell you that nothing seems to work quite as well as HRT for those severe, debilitating hot flashes.  And that is the biggest reason women end up taking HRT, hands down.  But if you have a history of breast cancer or blood clots, or if you have risk factors for heart attacks or strokes, you may choose not to take HRT—and you’ll have to have that conversation with your doctor.  If you choose not to, here are some other options to try:

  • Anti-depressants:  Anti-depressants such as venlafaxine, fluoxetine, and paroxetine have been shown to reduce hot flashes in some women.  And as a bonus, they may improve the mood swings as well!

  • Nerve pain/anti-seizure meds: Gabapentin is a medication often used to treat neuropathic pain or seizures that surprisingly may improve hot flashes in some women.

  • Anti-hypertensives:  Originally a blood pressure medicine, clonidine is typically prescribed as a pill or patch that may help those with hot flashes.  Some patients are unable to tolerate its side effects of dry mouth, constipation, and dizziness, however.  And it may be a good idea to monitor your blood pressures to make sure it doesn’t go too low while on it.

  • Soy products:  Products containing soy, like soy milk, have a natural estrogen-like derivative. Naturally, you might think they could possibly help with hot flashes, right?  The jury is out on that one, but soy products may be worth a good try!

  • Herbals:  Herbal products, such as black cohosh, have also been suggested as treatments. The evidence behind these products is also not so strong.  And over-the-counter herbal products are not FDA regulated, so we may not be able to tell how harmful they may be, if any. But I do have a few patients who swear by them.  Who knows…

A Word About Bioidentical Hormones

If you have suffered from menopausal symptoms, you must have heard the term “bioidentical hormones” by now.  The media seems to really have had a field day with this term in recent times, so you may be wondering what biodentical hormones really are.   The bioidentical part of the phrase refers to estrogen derivatives from plants and soy, and the hormone part refers to the fact that these derivatives are then modified to look structurally identical to human estrogen--hence the word “hormones.”

There’s a perception that because they are derived from more “natural” means, that they are safer.  However, there is no good evidence to support this claim. And many of the national health organizations, including the U.S. Food and Drug Admnistration (FDA) and American College of Obstetricians and Gynecologists (ACOG), have released statements that report on the limited safety and effectiveness of these preparations.  These hormones may have similar negative effects as HRT, and we just don’t know it yet.  Remember, just because something is labeled as “natural,” it doesn’t mean it’s better or safer. 

Please note that all content here is strictly for informational purposes only.  This content does not substitute any medical advice, and does not replace any medical judgment or reasoning by your own personal health provider.  Please always seek a licensed physician in your area regarding all health related questions and issues.

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