Menopause: Medical Treatment Options Available in Australia

Menopause in women is inevitable as we age. There is no getting around it. And if you can manage the symptoms of menopause, there is no need for any medical treatment.

But some women find that their menopause symptoms are particularly severe or they interfere with everyday life. There are many medical treatments that can ease the symptoms of menopause. Let's look at the medical treatment options available in Australia.

More Reading: What are the Signs You Need Hormone Replacement Therapy

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1. Hormone Replacement Therapy

Before even considering hormone replacement therapy, your Doctor will suggest a routine cervical cancer screening test (pap smear) and perhaps also send you for a Mammogram. Your Doctor will also check your general health.

This is a whole subject on itself, but Hormone Replacement Therapy is also the most widely known and successful treatment for the symptoms of menopause. There are two main types of Hormone Replacement Therapy, Combined HRT which is both Oestrogen and Progestogen which is for women who still have their uterus, and Oestrogen-only HRT for women who have undergone a hysterectomy.

Why Progestogen AND Oestrogen?

Well there is a small risk of uterine cancer with Oestrogen-only hormone replacement therapy - that's why women who still have a uterus need the progestogen combined with the oesterogen. A progestogen is a synthetic form on the female sex hormone preogesterone and it protects the uterine lining.

HRT comes in different doses, and is delivered in a variety of ways including:

• Transdermal Patch
• Gel
• Pessary
• Tablet
• Intrauterine device (IUD)

More Reading: The Ultimate Guide to Hormone Replacement Therapy

Combined HRT (Oestrogen and Progestogen)

For women who are perimenopausal and still have their uterus, a combined HRT will usually be prescribed. The Oestrogen will replace the lost oestrogen due to menopause, and will assist with the symptoms of menopause including hot flushes, night sweats, sleeplessness and more.

At first, your Doctor may put you on a low dosage of Combined HRT to see how your body responds. But you may have to try different dosages and different methods to find the right combination for you.

Oestrogen Only HRT

For women who have undergone a hysterectomy, an Oestrogen Only HRT is usually prescribed. Women who no longer have a uterus don't need the addition of Progestogen in their HRT as they have no risk of uterine cancer.

More Reading: What Does Menopause Fatigue Feel Like?

2. Oestrogen plus SERM (Selective Oestrogen Receptor Modulator)

A brand new treatment for menopause, Oestrogen Plus SERM (Selective Oestrogen Receptor Modulator) sounds pretty complicated. But really, SERM is a class of drug that 'activates' the oestrogen receptor modulators. That is, they 'manage' how oestrogen works in your body. SERMs are not just used for menopause, they are also used for some types of breast cancer and also osteoporosis.

Examples of 'Serm' medications include:

• Raloxifene
• Bazedoxifene
• Tibolone

SERMs sound very futuristic and they are, but they don't come without their negatives. Some can increase the chances of having blood clots.

As we find out more about SERMs - we will provide you with more information!

3. Vaginal Estrogen Pessaries

Vaginal Oestrogen is oestrogen (hormone replacement) that is medically delivered via a pessary that is inserted into the vagina. The oestrogen only affects the vaginal area of the body and limits the amount of oestrogen delivered.

This type of oestrogen will help with vaginal dryness and can increase your sex drive, and will make your vagina lovely and plump and full of blood which will increase your sex drive, but as it is localised to the vaginal area, it won't help with hot flushes or night sweats as it is exclusively delivered only to the vaginal cavity.

This is a great option for women who are hesitant to use HRT and want to 'dip their toes' into trying it. Plus, not all women have all menopausal symptoms, so if women are just experiencing a lack of sex drive and a dry vagina, this may be the perfect solution.

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4. Low Dose Antidepressants

Despite their name, antidepressants can treat a variety of conditions besides depression. There are many benefits of low dose antidepressants for the treatment of menopause as they can provide relief for 'vasomotor symptom's of menopause - that is, hot flushes, night sweats, migraines and skin flushing.

As almost 80% of menopausal women complain of these symptoms, it makes sense that a low dose antidepressant can be a great treatment.

A clinical trial undertaken in 2015 showed that a low dose of SSRI paroxetine even improved the sleep quality of menopausal women.

Discuss this as a possible treatment with your GP to see if you are a good candidate as this is considered an 'off-label' use of antidepressants.

More Reading: 10 Signs You Are Approaching Perimenopause

5. Calcium and Vitamin D Supplements to Prevent Osteoporosis

Last but not least, is Calcium and Vitamin D Supplements. These are over-the-counter supplements that aid in the prevention of osteoporosis which is more prevalent in menopausal women due to the lack of oestrogen.

Book a bone density test at your local GP and ask about dosages and recommended brands.

Sources:

Australasian Menopause Society

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