Menopause is a natural change that doesn't require treatment. However, symptoms of hormonal change can be difficult. If you have insomnia, mood swings, hot flashes, cloudy thinking, heavy menstrual periods, or other menopause symptoms, treatment can help you manage this transition more comfortably. As you review your options, consider the following:

• Healthy lifestyle habits will help you reduce menopause symptoms. These habits include eating a balanced diet; reducing stress; getting regular exercise; and avoiding smoking, heavy caffeine, and heavy alcohol use. An unhealthy lifestyle can make symptoms worse.
• Low-dose hormone therapy (HT) or low-dose birth control pills may be an option if you are still having periods and have multiple or severe symptoms. Birth control pills aren't used after menopause because they contain higher levels of hormones than women need.
• After menopause, hormone therapy can be used as a short-term treatment for severe symptoms when taken in as low a dose as possible.
• You may only need a specific treatment for certain symptoms, such as hot flashes or vaginal dryness.
• Meditative breathing, as well as supplements such as black cohosh or soy, may help relieve symptoms.

Recent studies have led to a big change in how health professionals use hormone therapy after menopause. For a long time, estrogen-progestin, or hormone replacement therapy (HRT), was thought to protect against heart disease or dementia. But studies now show that HRT use can cause serious health problems in a small number of women. These health problems include dangerous blood clots, stroke, heart disease, breast cancer, ovarian cancer, and dementia.^{8, 9, 10} The heart disease risk does not seem to affect women during their first 10 years after menopause.¹¹

Average HRT- and ERT-related risks are low among the general population of women. However, your personal risk that hormone therapy may stimulate breast cancer, ovarian cancer, cardiovascular problems, blood clots, or neurological changes may be lower or higher, depending on your risk factors for those health problems.

Treatment options for menopause symptoms

Hot flashes. Meditative breathing exercises (paced respiration) have been shown to reduce hot flashes.¹ Medications that can improve hot flashes include short-term, low-dose hormone therapy, selective serotonin reuptake inhibitor (SSRI) antidepressants such as fluoxetine and paroxetine (for example, Paxil and Prozac), the high blood pressure medication clonidine, and the antiseizure medication gabapentin (Neurontin).^{12, 13}

Heavy periods. The hormone progestin can help relieve heavy menstrual bleeding caused by low progesterone levels (after you have an exam to rule out other possible causes). Other options include nonsteroidal anti-inflammatory drugs (NSAIDs), the levonorgestrel (LNg) IUD, or birth control pills. For severe blood loss, some women choose permanent surgical treatment. These options include removing the uterus (hysterectomy) or using heat energy to damage and scar the wall of the uterus (endometrial ablation). For more information, see the topic Dysfunctional Uterine Bleeding.