Menopause Treatment: More Options, Better Evidence, Real Relief.
Understanding Menopause
There is no one-size-fits-all approach to menopause care. Treatment decisions are deeply personal and depend on your symptoms, health history, and preferences. The good news is that there are more options available than ever before — both hormonal and non-hormonal — and for most women, effective relief is achievable. All of the treatments outlined below are ones I am able to prescribe, so once we determine the best fit for you, we can move forward together without the need for additional referrals.
Hormonal Treatments
Hormone therapy (HT) remains the most effective treatment for the symptoms of perimenopause and menopause. It has evolved significantly over the decades, and we now have a much clearer and more reassuring understanding of its safety profile for most women.
Estrogen is the cornerstone of hormone therapy and the most effective treatment for hot flashes, night sweats, sleep disruption, mood changes, and genitourinary symptoms
Progesterone is added for women who have a uterus, to protect the uterine lining — the combination of estrogen and progesterone is the standard approach for most women in this group
Oral contraceptive pills are sometimes the best option, particularly for perimenopausal women who still need contraception or whose symptoms are better managed with the hormonal stability the pill provides
Hormonal IUDs offer a dual benefit — managing heavy or irregular perimenopausal bleeding while simultaneously providing the uterine protection needed to take estrogen safely
Local vaginal estrogen — treats genitourinary symptoms like vaginal dryness, irritation, and painful sex directly, with minimal systemic absorption, and can be used alongside other hormone therapy or on its own
A thorough risk assessment is an essential part of any hormonal treatment discussion. There are some women for whom hormone therapy is not recommended, and understanding your individual risk profile is an important first step. That said, current evidence is reassuring — for the majority of women, hormone therapy is a safe and highly effective option.
Non-Hormonal Treatments
For women who cannot or prefer not to use hormones, there are several effective non-hormonal options:
Certain antidepressants and anti-seizure medications have good evidence for reducing hot flashes and improving mood and sleep, and are a well-established alternative for many women
Neurokinin B (NK3) receptor antagonists represent one of the most significant advances in menopause treatment in recent years. These medications work directly on the brain's thermoregulation centre — addressing the root cause of hot flashes rather than managing them indirectly. They are a particularly important option for women who cannot take hormonal therapy due to their health history and risk factors
CBT-I and psychological therapies for sleep and mood — as discussed in our sleep and mental health sections
Lifestyle approaches — including exercise, nutrition, stress management, and sleep hygiene — play a meaningful supporting role alongside any treatment plan
Find the Treatment Approach That’s Right for You
Menopause care is not one-size-fits-all. Whether you are considering hormone therapy, exploring non-hormonal options, or simply looking for answers, we will take the time to understand your symptoms, health history, and goals. Together, we can create a personalized treatment plan to help you feel supported and confident through every stage of your menopause journey.