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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.
This page covers the following alternatives to standard HRT:
The following lifestyle measures can help reduce some menopausal symptoms:
Tibolone (brand name Livial) is a prescription medication 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.
Two types of antidepressants – called selective serotonin reuptake inhibitors (SSRIs) and serotonin-noradrenaline reuptake inhibitors (SNRIs) – can help with hot flushes caused by the menopause, although they're not licensed for this use.
This means they haven't undergone clinical trials for this use, but many experts believe they're likely to be effective and your doctor will discuss the possible benefits and risks with you.
Side effects of SSRIs and SNRIs can include feeling agitated, shaky or anxious, feeling sick, dizziness and a reduced sex drive.
Any side effects will usually improve over time, but you should visit your GP if they don't.
Clonidine is a prescription medicine that can help reduce hot flushes and night sweats in some menopausal women. It's taken as tablets two or three times a day.
It doesn't affect hormone levels, so unlike HRT it doesn't 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 two to four weeks to notice the effects of clonidine. Speak to your GP if your symptoms don't improve or you experience any 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 preparations.
However, bioidentical preparations aren't recommended because:
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 generally, many complementary therapies aren't supported by scientific evidence.
Even when there is some supporting evidence, there's uncertainty about the appropriate doses to use and whether the health benefits are sustained. Some of these remedies (especially St John's wort) may also cause serious effects if taken with other medicines.
These products are often marketed as "natural", but this doesn't necessarily mean they're safe. The quality, purity and ingredients can't always be guaranteed, and they can cause unpleasant side effects.
It's a good idea to ask your GP or pharmacist for advice if you're thinking about using a complementary therapy.