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Menopause Drugs and Medications

Treating Hot Flashes, Bone Loss, and Vaginal Dryness

There are a number of prescription and over-the-counter medications available to treat the symptoms of menopause. This article focuses on treatments for the 3 most common symptoms and complications: hot flashes, bone loss, and vaginal dryness.

Hot Flashes
Drugs and medications that treat hot flashes include:

  • Hormone therapy: Hormone therapy (also known as estrogen plus progestogen therapy) is widely considered the best treatment for moderate to severe hot flashes. Plus, it is the only FDA-approved medication for hot flashes. Another benefit of hormone therapy is that it will help prevent bone loss because estrogen supports your bone-building cells, called osteoblasts.

    In most cases, the lowest possible dose taken for the shortest amount of time is the best strategy to provide relief while limiting the risks associated with hormone therapy (which include an increased uterine cancer, breast cancer and stroke risk). Your doctor will work with you to determine your appropriate dose and length of treatment.

    Some women present certain risk factors that prevent them from taking hormone therapy. These risks include a history of breast cancer, blood clots, and abnormal uterine bleeding.

If you cannot take hormone therapy to manage your hot flashes, there are non-hormonal prescription medications available that may help. While they may relieve your discomfort, none of the below treatments are FDA-approved to treat hot flashes:

  • Anti-depressants: A low dose of venlafaxine (marketed as Effexor) may help relieve hot flashes. Venlafaxine belongs to a newer class of anti-depressants, known as selective serotonin reuptake inhibitors (SSRIs). Fluoxetine hydrochloride (Prozac) and sertraline hydrochloride (Zoloft) are other SSRIs that may reduce hot flashes.

    SSRIs boost your mood by allowing more serotonin to travel from neuron to neuron. More serotonin means less pain perception. In addition to reducing hot flashes, SSRIs may also help eliminate fatigue.

     

  • Clonidine: Marketed as Catapres in the US, clonidine is typically used to treat high blood pressure. But it has also reduced hot flashes in some women.

     

  • Gabapentin: Marketed as Neurontin, gabapentin is a common medication for seizures. But like SSRIs and clonidine, it may also help control hot flashes. It may be especially effective for women with nocturnal symptoms.

Bone Loss
Menopause puts women at risk for developing osteoporosis, so your doctor may prescribe a medication to help prevent bone loss. Medications that may reduce your risk for developing osteoporosis are:

  • Estrogen agonists/antagonists: Also known as selective estrogen receptor modulators (SERMs), estrogen agonists/antagonists offer the bone health benefits of hormone therapy but without the increased cancer risks. There is one approved estrogen agonist/antagonist used to treat osteoporosis-raloxifene, which is marketed as Evista.

     

  • Bisphosphonates: Bisphosphonates increase your bone mineral density by slowing down the work of osteoclasts (bone-absorbing cells). Alendronate (marketed as Fosamax), ibandronate (Boniva), risedronate (Actonel), and zoledronic acid (Reclast) are FDA-approved bisphosphonates.

To learn more about preventing bone loss after menopause, read our article about osteoporosis prevention.

Vaginal Dryness
The treatments below relieve vaginal dryness:

  • Vaginal estrogen: Available by prescription in a cream, tablet, or ring, vaginal estrogen delivers a small amount of estrogen to the vaginal tissues. This helps maintain a healthy moisture balance. For women with certain risk factors that prevent them from taking estrogen pills, vaginal estrogen may still be a safe option.

     

  • Vaginal lubricants and moisturizers: If you're looking for an over-the-counter option, there are a number of vaginal lubricants (Astroglide and K-Y) and moisturizers (Vagisil) available to relieve vaginal dryness.

Though the symptoms of menopause are a completely normal part of the transition, that doesn't mean you have to endure them. Fortunately, there are a variety of prescription and over-the-counter medications available to help treat your symptoms. Talk with your doctor to explore the best treatment plan for you.

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