Skip to main content
SpringerLink
Log in

Non-Hormonal Management of the Menopause

  • Chapter
  • First Online:
Menopause

  • 1266 Accesses

Abstract

The menopause can be associated with a number of symptoms, including hot flushes and night sweats (vasomotor symptoms), vaginal symptoms, depression, anxiety, irritability and mood swings (psychological effects), joint pains, migraines or headaches, sleeping problems and urinary incontinence. Vasomotor symptoms are the most commonly reported, and these are treated effectively with HRT, but there are a group of women for whom HRT is not suitable, and for these reasons, there is an interest in non-hormonal alternatives.

Clonidine, SSRIs and gabapentin, and a number of over-the-counter remedies, as well as alternative therapies, are all used as alternatives to HRT, but not all are effective. This chapter addresses some of the most commonly used non-hormonal treatments for symptoms of the menopause.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. National Institutes of Health. National Institutes of Health State-of-the-Science Conference Statement: management of menopause-related symptoms. Ann Intern Med. 2005;142(12 Pt 1):1003–13.

    Google Scholar 

  2. Avis NE, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015;175(4):531–9.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Freedman RR. Menopausal hot flashes: mechanisms, endocrinology, treatment. J Steroid Biochem Mol Biol. 2014;142:115–20.

    Article  CAS  PubMed  Google Scholar 

  4. The National Institute for Health and Care Excellence. Menopause: diagnosis and management of menopause. (NICE guideline).

    Google Scholar 

  5. Daley A, et al. Exercise for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2007;4:CD006108.

    Google Scholar 

  6. Kroenke CH, et al. Effects of a dietary intervention and weight change on vasomotor symptoms in the Women’s Health Initiative. Menopause. 2012;19(9):980–8.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Nelson HD, et al. Nonhormonal therapies for menopausal hot flashes: systematic review and meta-analysis. JAMA. 2006;295(17):2057–71.

    Article  CAS  PubMed  Google Scholar 

  8. Rada G, et al. Non-hormonal interventions for hot flushes in women with a history of breast cancer. Cochrane Database Syst Rev. 2010;9:CD004923.

    Google Scholar 

  9. Shams T, et al. SSRIs for hot flashes: a systematic review and meta-analysis of randomized trials. J Gen Intern Med. 2014;29(1):204–13.

    Article  PubMed  Google Scholar 

  10. Sun Z, Hao Y, Zhang M. Efficacy and safety of desvenlafaxine treatment for hot flashes associated with menopause: a meta-analysis of randomized controlled trials. Gynecol Obstet Investig. 2013;75(4):255–62.

    Article  CAS  Google Scholar 

  11. Lethaby A, et al. Phytoestrogens for vasomotor menopausal symptoms. Cochrane Database Syst Rev. 2007;4:CD001395.

    Google Scholar 

  12. Leach MJ, Moore V. Black cohosh (Cimicifuga spp.) for menopausal symptoms. Cochrane Database Syst Rev. 2012;9:CD007244.

    Google Scholar 

  13. Wong VC, et al. Current alternative and complementary therapies used in menopause. Gynecol Endocrinol. 2009;25(3):166–74.

    Article  CAS  PubMed  Google Scholar 

  14. Newton KM, et al. Treatment of vasomotor symptoms of menopause with black cohosh, multibotanicals, soy, hormone therapy, or placebo: a randomized trial. Ann Intern Med. 2005;145:869–79.

    Article  Google Scholar 

  15. Circosta C, et al. Estrogenic activity of standardized extract of Angelica sinensis. Phytother Res. 2006;20(8):665–9.

    Article  CAS  PubMed  Google Scholar 

  16. The North American Menopause Society (NAMS). Nonhormonal management of menopause-associated vasomotor symptoms: 2015 position statement of The North American Menopause Society. Menopause. 2015;22(11):1155–74.

    Article  Google Scholar 

  17. Barton DL, et al. Prospective evaluation of vitamin E for hot flashes in breast cancer survivors. J Clin Oncol. 1998;16(2):495–500.

    Article  CAS  PubMed  Google Scholar 

  18. Biglia N, et al. Non-hormonal treatment of hot flushes in breast cancer survivors: gabapentin vs. vitamin E. Climacteric. 2009;12(4):310–8.

    Article  CAS  PubMed  Google Scholar 

  19. Ziaei S, Kazemnejad A, Zareai M. The effect of vitamin E on hot flashes in menopausal women. Gynecol Obstet Investig. 2007;64(4):204–7.

    Article  CAS  Google Scholar 

  20. Chenoy R, et al. Effect of oral gamolenic acid from evening primrose oil on menopausal flushing. BMJ. 1994;308(6927):501–3.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Mann E, et al. A randomised controlled trial of a cognitive behavioural intervention for women who have menopausal symptoms following breast cancer treatment (MENOS 1): trial protocol. BMC Cancer. 2011;11:44.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ayers B, et al. Effectiveness of group and self-help cognitive behavior therapy in reducing problematic menopausal hot flushes and night sweats (MENOS 2): a randomized controlled trial. Menopause. 2012;19(7):749–59.

    Article  PubMed  Google Scholar 

  23. Hunter MS. Beliefs about hot flashes drive treatment benefit. Menopause. 2014;21(8):909.

    Article  PubMed  Google Scholar 

  24. Dodin S, et al. Acupuncture for menopausal hot flushes. Cochrane Database Syst Rev. 2013;7:CD007410.

    Google Scholar 

  25. Cho SH, Whang WW. Acupuncture for vasomotor menopausal symptoms: a systematic review. Menopause. 2009;16(5):1065–73.

    Article  PubMed  Google Scholar 

  26. Lee MS, et al. Acupuncture for treating hot flushes in men with prostate cancer: a systematic review. Support Care Cancer. 2009;17(7):763–70.

    Article  PubMed  Google Scholar 

  27. van Gastel P, et al. Stellate-ganglion block as a treatment for severe postmenopausal flushing. Climacteric. 2013;16(1):41–7.

    Article  PubMed  Google Scholar 

  28. Lipov EG, et al. Updated findings on the effects of stellate-ganglion block on hot flushes and night awakenings. Lancet Oncol. 2008;9(9):819–20.

    Article  PubMed  Google Scholar 

  29. Pachman DR, et al. Pilot evaluation of a stellate ganglion block for the treatment of hot flashes. Support Care Cancer. 2011;19(7):941–7.

    Article  PubMed  Google Scholar 

  30. Haest K, et al. Stellate ganglion block for the management of hot flashes and sleep disturbances in breast cancer survivors: an uncontrolled experimental study with 24 weeks of follow-up. Ann Oncol. 2012;23(6):1449–54.

    Article  CAS  PubMed  Google Scholar 

  31. Seminara SB, et al. The GPR54 gene as a regulator of puberty. N Engl J Med. 2003;349(17):1614–27.

    Article  CAS  PubMed  Google Scholar 

  32. Krajewski SJ, et al. Forebrain projections of arcuate neurokinin B neurons demonstrated by anterograde tract-tracing and monosodium glutamate lesions in the rat. Neuroscience. 2010;166(2):680–97.

    Article  CAS  PubMed  Google Scholar 

  33. Jayasena CN, et al. Neurokinin B administration induces hot flushes in women. Sci Rep. 2015;5:8466.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric. 2010;13(6):509–22.

    Article  CAS  PubMed  Google Scholar 

  35. Bachmann GA, et al. Sexual expression and its determinants in the post-menopausal woman. Maturitas. 1984;6(1):19–29.

    Article  CAS  PubMed  Google Scholar 

  36. Suckling JA, et al. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2006;4:CD001500.

    Google Scholar 

  37. Le Ray I, et al. Local estrogen therapy and risk of breast cancer recurrence among hormone-treated patients: a nested case–control study. Breast Cancer Res Treat. 2012;135(2):603–9.

    Article  PubMed  Google Scholar 

  38. Wills S, et al. Effects of vaginal estrogens on serum estradiol levels in postmenopausal breast cancer survivors and women at risk of breast cancer taking an aromatase inhibitor or a selective estrogen receptor modulator. J Oncol Pract. 2012;8(3):144–8.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Biglia N, et al. Low-dose vaginal estrogens or vaginal moisturizer in breast cancer survivors with urogenital atrophy: a preliminary study. Gynecol Endocrinol. 2010;26(6):404–12.

    Article  CAS  PubMed  Google Scholar 

  40. Portman DJ, et al. Ospemifene, a novel selective estrogen receptor modulator for treating dyspareunia associated with postmenopausal vulvar and vaginal atrophy. Menopause. 2013;20(6):623–30.

    Article  PubMed  Google Scholar 

  41. Bachmann GA, Komi JO, Ospemifene Study G. Ospemifene effectively treats vulvovaginal atrophy in postmenopausal women: results from a pivotal phase 3 study. Menopause. 2010;17(3):480–6.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Obstetrics and Gynaecology, School of Medicine, College of Medical, Veterinary and Life Sciences University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, 10-16 Alexandra Parade, Glasgow, G31 2ER, UK

    Jenifer Sassarini M.B.Ch.B., Ph.D., M.R.C.O.G. & Mary Ann Lumsden

Authors
  1. Jenifer Sassarini M.B.Ch.B., Ph.D., M.R.C.O.G.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mary Ann Lumsden
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jenifer Sassarini M.B.Ch.B., Ph.D., M.R.C.O.G. .

Editor information

Editors and Affiliations

  1. Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain

    Antonio Cano

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Sassarini, J., Lumsden, M.A. (2017). Non-Hormonal Management of the Menopause. In: Cano, A. (eds) Menopause. Springer, Cham. https://doi.org/10.1007/978-3-319-59318-0_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-59318-0_15

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-59317-3

  • Online ISBN: 978-3-319-59318-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation