Menopause: How to choose the best treatment for you

Troublesome symptoms of menopause are a fact of life for some women but many are unsure which treatment options are safe and effective and don’t feel confident discussing options with their health professional.

While hormone replacement therapy (HRT) has received mixed reviews in recent years, the National Prescribing Service (NPS) says for some women it’s still the most effective option if a decision is made to use a medicine.

"Research indicates that HRT – oestrogen with or without progestogen – can result in a 75 percent reduction in hot flush frequency per week compared to placebo," NPS senior adviser, quality use of medicines, Judith Mackson said.

"Women may be reluctant to use HRT following media reports on the concerns and risks of HRT. This has led to an increased interest in alternate therapies such as vitamins and herbs. Even though complementary medicines appear safer, there is little clinical evidence supporting their efficacy. Alternate remedies should always be taken with the same caution as any other medicine," Ms Mackson said.

The final menstrual period generally happens when women are between 40 and 58 years old. As the production of oestrogen by the ovaries slows down, hormone levels change and fluctuate sometimes causing symptoms such as hot flushes and/or night sweats, trouble sleeping and vaginal dryness. Lifestyle factors like smoking can hasten the onset of menopause.

What to do if you think you’re beginning menopause:

• Discuss any symptoms with your doctor
• Provide your doctor with your personal and family history relating to menopause and cardiovascular health
• Talk to your doctor about the harms and benefits of HRT, and what the harms may be for you
• Ask your doctor about how lifestyle changes can help relieve symptoms
• Tell your doctor about any medicines, including over-the-counter and vitamins or herbs, you are taking or thinking about taking
• Keep a record of any symptoms including duration and severity to discuss at your next appointment with your doctor.

"Women today are juggling busy lives and want control over their health and wellbeing. Menopause can be a difficult experience and often comes at a time when a woman’s family life and career are changing too," Ms Mackson said.

"The decision about which treatment option to use should be made jointly between the doctor and patient. Women need to feel they can discuss all their options with their doctor and know that their treatment plan is the most appropriate for their individual circumstances."

(Source: National Prescribing Service (NPS): August 2009)