Menopause without HRT: your other options
Some people can’t take HRT, and some would rather not. Either way, there is plenty that helps.
Cognitive behavioural therapy (CBT)
NICE recommends CBT for hot flushes and night sweats, and for low mood and anxiety linked to menopause. It doesn’t make symptoms disappear, but it reliably reduces how much they bother you, and it helps with sleep.
Non-hormonal medicines
Several prescription medicines reduce hot flushes, including some originally developed for other conditions and a newer class designed specifically for menopausal flushes. Each has its own benefits, side effects and suitability, so they are chosen individually.
Vagina and bladder
Vaginal moisturisers used regularly and lubricants during sex help many people. Vaginal oestrogen is very low dose and is often still an option for people who can’t take other HRT; we can talk through whether it suits you.
Lifestyle
- Regular exercise, including strength training, for mood, sleep, bones and weight
- Cutting down alcohol, caffeine and spicy food if they trigger flushes
- Stopping smoking
- Layered clothing and a cooler bedroom
Supplements and herbal remedies
Many are sold for menopause, but evidence that they work is weak, quality varies, and some interact with other medicines or aren’t safe after breast cancer. Tell your doctor about anything you take.
Pelvic health physiotherapy
Specialist physiotherapy can help with bladder leaks, urgency and pelvic floor weakness.
Want advice that fits you? Every menopause is different.
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