Treatment options during the menopause

Hormone replacement therapy (HRT)

HRT has been extensively studied. As a result, it is currently considered the most effective form of treatment, particularly for hot flushes, night sweats and vaginal dryness. 1,2 Other menopause-related disorders can also be alleviated or eliminated. 3 Hormone replacement products also have a preventive effect, positively influencing the course of certain diseases and improving bone health, for example.

Non-drug forms of therapy

In addition to HRT, there are other options for treating menopausal disorders, the best known of which are :

  • Active plant substances

Some herbal ingredients have estrogen-like effects and are thought to play a regulating role in the female hormonal balance. In most cases, however, herbal remedies do not, or only indirectly, address the real cause of the disorder, i.e. the lack of endogenous hormones. What's more, there are no large-scale scientific studies to date on the long-term use of these preparations, with only small studies suggesting efficacy against hot flushes. 4

  • Cognitive Behavioral Therapy (CBT)

Different methods of therapy have been examined: CBT, MBCT (mindfulness-based therapy) and BHT (behavioral therapy). 2 . All three therapies have been shown to improve menopausal symptoms.

  • Yoga

The evidence regarding the efficacy of yoga in the treatment of hot flushes or sleep disorders is not unanimous. In the case of very serious disorders, it does not appear to be an effective treatment option.

What are the arguments in favor of hormones during menopause?

Hormone replacement therapy (HRT) is considered the most effective way of regulating hormones. Hot flushes and sweating, known as vasomotor disorders, which frequently occur during menopause, can be treated most effectively with HRT, as can organic disorders such as vaginal dryness, which can have a considerable impact on quality of life. 5

References

    1. Birkhäuser M. Menopausale Hormontherapie aus heutiger Sicht. Gynäkologie. 3/2018:18-22

    2. van Driel CM et al. Mindfulness, cognitive behavioural and behaviour-based therapy for natural and treatment-induced menopausal symptoms: a systematic review and meta-analysis. BJOG 2018.

    3. Mueck AO. Anwendungsempfehlungen zur Hormonsubstitution im Klimakterium und Postmenopause. Frauenarzt 2015;56:657-9

    4. Liu YR et al. Hypericum perforatum L. preparations for menopause: a meta-analysis of efficacy and safety. Climacteric 2014;17(4):325-35

    5. Grant, MD, et al. (2015). Menopausal Symptoms: Comparative Effectiveness of Therapies, https://www.ncbi.nlm.nih.gov/sites/books/NBK285463/