A guide to menopause treatment options: from chickpeas to HRT

Up until very recently the menopause was something that was tolerated at best, and survived at worst. It wasn't discussed and was often ignored by the medical establishment. Today's women quite rightly demand more, but media stories and old wive's tales abound. Getting accurate and relevant information can at times feel like an uphill struggle.

Eight out of ten women will at some stage be affected by distressing menopausal symptoms, yet statistically very few will go to see their doctor for advice. New guidance published at the end of last year has changed the medical landscape and never before have so many options and choices been available to us. As a practising GP I hugely welcome this and am passionate about empowering women to make positive choices for themselves.

  • Hormone replacement therapy (HRT) has been around for many decades and remains a popular treatment option. Hot flushes may be synonymous with the menopause, but low mood, lack of libido and vaginal dryness are just a few of the extremely common but less talked about symptoms. We now know that HRT can be helpful in addressing all of these complaints, in addition to helping reduce the chance of broken bones due to osteoporosis.
  • Despite the positive news there are small but important risks of HRT. It is estimated that in the UK around two in 1,000 women will develop breast cancer related to HRT. Discussing with a doctor how such risks personally apply to you is a really important step before embarking on treatment.
  • Oestrogen creams or pessaries can be invaluable in helping vaginal dryness and discomfort, and for most women are very safe to use.
  • Alternative therapies can be seen as the holy grail for many, and there is an abundance of choices on both the high street and internet. Phyto-oestrogens found in soybeans, chickpeas, flaxseed and some whole cereals are molecularly very similar to human oestrogen. For this reason they are often marketed as a natural version of HRT. The general consensus appears to be that eating them in moderation may not only help your menopausal symptoms but also offer a host of other benefits. However, the science remains contradictory and the jury is still out.
  • Cognitive behavioural therapy (CBT) has been shown to be very helpful in dealing with low mood triggered by the menopause.
  • There is some evidence that the herbal remedies black cohosh and St John's wort may also be beneficial in menopause. Care should be taken if you are on regular prescription medication. Always buy from reputable suppliers.
  • Unfortunately currently there is no robust scientific backing for a host of other popular alternative remedies and treatments such as acupuncture, reflexology, homeopathy or vitamin supplements.

Menopause is something that affects all women and the time has come for us to be more comfortable talking about it. The era of patients being told to 'get on with it' has passed as more and more options become available. Speak to your friends, discuss with your doctor and above all do what feels right for you.

Dr Jessica Garner is a GP and health blogger. Visit her blog here.


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