Menopause is not a disease that requires treatment, though it may feel that way sometimes. It’s actually a normal life stage that all women go through when they come to the end of their childbearing years. Since sometimes women may think they’re in menopause when actually they may be pregnant (because symptoms of both can include hot flashes and weight gain), it’s important to let your doctor know if this is a possibility. That said, declining estrogen levels can cause a range of bothersome symptoms, including hot flashes, vaginal dryness, sleep problems, and urinary issues.
In the past, menopausal women were routinely prescribed hormone replacement therapy (HRT), which we long believed was the best way to not only manage the symptoms of menopause but also prevent heart disease and stroke. All that changed about 20 years ago, when a major study revealed that HRT actually increased the risk of heart attack, stroke, and breast cancer. Today, we still sometimes prescribe HRT for women who have extremely severe hot flashes—but only if they’re not at high risk for breast cancer, stroke, or heart disease, and only if their breast and gynecological exams are normal and up to date—and only in the lowest possible dose, for as short of a time as possible.
More often, we advise women to use a variety of strategies to combat the most common menopause symptoms, as well as the conditions that are more likely to occur at this stage of life. Here’s what I recommend: