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Menopause minus HT

Menopausal hormone therapy, or HT, has undergone quite an image makeover in recent years.

Not long ago, experts promoted it as a one-stop medication for menopausal symptoms and protection against heart disease and osteoporosis. Now, HT’s profile has diminished—a major nationwide study linked one commonly prescribed form of the therapy to higher risks of heart attack, stroke, blood clots and breast cancer.

Reviewing your options

For short-term use, experts note that HT is still the most effective medicine available to quell hot flashes, sleeplessness, night sweats and vaginal dryness. But more women than ever are looking for safe, non-hormonal alternatives. Talk to your doctor and consider these simple suggestions:

Hot flashes

When you feel a hot flash coming on, take slow, deep breaths, and the hot flash may be lessened or avoided completely. Dress in layers and sleep in a cool room.

Avoid drinking hot beverages, especially those containing caffeine, and consuming hot soups. Drinking alcohol and eating spicy foods can also trigger hot flashes. Some research shows that adding a daily serving of soy foods to your diet or taking a supplement of black cohosh can relieve mild hot flashes. Keep in mind, though, that it may take a few weeks before you notice a difference.

Exercise can help as well. Active women seem to be less prone to hot flashes. This may be because exercise improves circulation, making your body more tolerant of temperature extremes and able to cool down more quickly.

For help with more severe hot flashes, prescription medications are available. Antidepressants called selective serotonin reuptake inhibitors (SSRIs), for example, may help manage hot flashes in women without cancer.

Difficulty sleeping

Many women notice that when they treat their hot flashes, sleep quality improves. Exercise helps here, too, by promoting nighttime sleepiness. Just be sure you don’t exercise close to bedtime or you’ll be too wide awake to fall asleep. It’s an added bonus that getting plenty of shut-eye can also help sharpen your concentration and eliminate the depression and short-term memory problems that are frequently a product of sleeplessness.

Vaginal dryness

Vaginal shrinking and dryness make intercourse uncomfortable or painful, causing some women to be less interested in sex. Over-the-counter moisturizers and lubricants can lubricate the vagina. Staying sexually active can help, too, by preventing or slowing vaginal changes. However, severe cases of vaginal dryness may respond only to prescription estrogen for use specifically inside the vagina. Note, though, that these preparations only work locally and therefore do not help with hot flashes.

Bladder control

Some women have problems with bladder control after menopause begins because lower hormone levels can relax the pelvic muscles. Simple exercises—known as Kegels—will strengthen pelvic floor muscles and help prevent leakage.

Start with the basics for overall good health—and start now: Eat a balanced, high-fiber, low-fat diet full of fruits, vegetables and whole grains. If you smoke, quit. And get plenty of exercise—it may help you reduce hot flashes, get a good night’s sleep, slow or prevent bone loss and even fight off weight gain and cardiovascular disease.

Protect your heart and bones

Since HT is no longer recommended for maintaining heart health and may be too risky to continue using to help bones stay strong, you and your doctor should discuss:

Heart disease. After menopause, a woman’s risk of heart disease steadily rises. But there are other ways to lower your risk besides HT. Keep moving; regular exercise helps lower your blood pressure and keep your cholesterol in check. If lifestyle measures don’t help, your doctor may prescribe a statin or other cholesterol-lowering drug.

Osteoporosis. A woman’s risk of osteoporosis (thin, fragile bones) increases after menopause. To ward off the condition without HT, make sure your diet provides plenty of calcium and vitamin D. Stay active as well. Weight-bearing exercises such as walking, running, weight training and aerobics are the best activities to help minimize bone loss. And talk to your doctor about non-hormonal medications.

What about supplements and botanicals for relief?

They may be “natural,” but herbal therapies have not been examined extensively enough to determine how well they work or how safe they are. They may have adverse side effects or cause dangerous interactions with other medications you’re taking.

Manufacturers of botanicals do not have to provide evidence to support their claims of relief, success or cure. Also, botanicals vary greatly in potency; plants grown in the field may be more or less potent due to growing conditions, and after processing, products may vary greatly in the amount of active ingredients.

Check with your doctor before taking any drug, supplement or alternative medication to treat menopause or any other symptoms.