Are there medications for symptoms of menopause that are not hormones?

Dr Alison Vickers, a Sydney GP with a special interest in the care of women during perimenopause and menopause, explains

The short answer

Yes, there are non-hormonal treatments that can be a good option. They are generally not as effective as hormone therapy for managing menopausal symptoms and don’t prevent bone loss or vaginal dryness. They may, however, offer other benefits.

The long answer

Why would some women consider other treatments?

Some women decide, after weighing up the risks and benefits, not to take hormone therapy. Others can’t take Menopause Hormone Therapy (MHT) because of conditions such as breast cancer, prior blood clots or other medical conditions. 

Fortunately, there are other treatments that we know also help manage symptoms of perimenopause/menopause.

While they may not be as effective as MHT (which will improve symptoms in 90% of women), they can still make an important difference.

What are some of the other treatments options?

Anxiety /depression tablets called SSRIs/SNRIs: decrease hot flushes by about 60% and positively affect mental health, sleep and general quality of life.

Seizure tablets: decrease electrical activity in the brain, and can decrease hot flushes by up to 80%. They also improve sleep.

Clonidine blood pressure tablets: can help migraines and decrease flushes by 40%. Due to this low level of effectiveness, most doctors no longer recommend clonidine as the best alternative choice for menopausal symptoms.

Oxybutynin tablets: used for some bladder problems improve flushes by about 50%.

Fezolinetant is a new medication only just available in Australia. It acts directly on a receptor in the brain to stop hot flushes. It has been shown to decrease flushes by about 50%

None of these medications will help with vaginal dryness. However, most women can use estrogen hormone vaginal cream safely alongside these medications.