If you're unable to take hormone replacement therapy (HRT) or decide not to, you may want to consider alternative ways of controlling your menopausal symptoms.
The following lifestyle measures can help reduce some menopausal symptoms:
Tibolone (brand name Livial) is a prescription medicine that is similar to taking combined HRT (oestrogen and progestogen). It's taken as a tablet once a day.
It can help relieve symptoms such as hot flushes, low mood and reduced sex drive, although some studies have suggested it may not be as effective as combined HRT.
It's only suitable for women who had their last period more than a year ago (known as the post-menopause).
Risks of tibolone are similar to the risks of HRT, and include an increased risk of breast cancer and strokes. Talk to your GP about the risks and benefits of tibolone if you're considering taking it.
There are 2 types of antidepressants – selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) – which may help with hot flushes caused by the menopause.
These medicines are not licensed for this use. This means they have not undergone clinical trials to test if they help this symptom, but many experts believe they're likely to help and your doctor will discuss the possible benefits and risks with you.
Any side effects will usually improve over time, but you should see a GP if they do not.
Clonidine is a prescription medicine that can help reduce hot flushes and night sweats in some menopausal women. It's taken as tablets 2 or 3 times a day.
It does not affect hormone levels, so unlike HRT it does not carry an increased risk of problems such as breast cancer. But research suggests it only has a very small effect on menopausal symptoms.
It may take 2 to 4 weeks to notice the effects of clonidine. Speak to a GP if your symptoms do not improve or you experience troublesome side effects.
Bioidentical hormones are hormone preparations made from plant sources that are promoted as being similar or identical to human hormones.
Practitioners claim these hormones are a "natural" and safer alternative to standard HRT medicines.
However, bioidentical preparations are not recommended because:
Bioidentical hormones are not the same as body identical hormones. A body identical hormone, or micronised progesterone, can be prescribed to treat menopausal symptoms.
Many standard HRT hormones are made from natural sources, but unlike bioidentical hormones, they're closely regulated and have been well researched to ensure they're as effective and safe as possible.
Several products are sold in health shops for treating menopausal symptoms, including herbal remedies such as evening primrose oil, black cohosh, angelica, ginseng and St John's wort.
There's evidence to suggest that some of these remedies, including black cohosh and St John's wort, may help reduce hot flushes, but many complementary therapies are not supported by scientific evidence.
Even when there is some supporting evidence, there's uncertainty about the right doses to use and whether the health benefits last. Some of these remedies (especially St John's wort) may also cause serious side effects if they're taken with other medicines.
These products are often marketed as "natural", but this does not necessarily mean they're safe. The quality, purity and ingredients cannot always be guaranteed, and they may cause unpleasant side effects.
It's a good idea to ask a GP or pharmacist for advice if you're thinking about using a complementary therapy.