• Posted June 20, 2023

The Most Common Menopause Medications, Explained

Menopause can usher in an array of bothersome symptoms, and finding effective relief becomes a priority for many women. The good news: Medications can help manage these symptoms and improve your overall quality of life.

Read on to learn about the most common menopause medications, how they work and their common side effects. Understanding your options during this transitional phase of life can help you make informed decisions in collaboration with your health care providers.

Menopause medications

A wide array of medications are available to help you manage menopause symptoms, each targeting specific kinds of relief. This section will explore the various types of menopause medications, including their benefits and common side effects associated with each drug category.

From hormone therapy, lubricants, moisturizers to other specialized treatments like antidepressants, medications can play a vital role in alleviating menopause-related discomfort.

Hormone therapy

Hormone therapy is a standard treatment for managing menopause symptoms, relieving hot flashes, vaginal dryness and related concerns. These are some commonly prescribed hormone therapy drugs, according to the U.S. Food and Drug Administration:

• Estrogen (Premarin, Estrace)
• Estrogen with progestin (Prempro, Activella)
• Progestin (Provera, Prometrium)

The first three categories of medications -- estrogen, estrogen with progestin, and progestin -- replenish declining hormone levels in the body, addressing the underlying hormonal imbalance. It's essential, however, to be aware of potential side effects, such as breast tenderness, bloating and mood swings, which may vary depending on the medication used.

Further, Mayo Clinic points out that in extensive clinical trials, estrogen-progestin hormone replacement pills have been associated with an increased risk of severe conditions, including heart disease, stroke, blood clots and breast cancer. Subsequent research has indicated that these risks may vary based on several factors.

For example, age plays a role. Starting hormone therapy before age 60 or within 10 years of menopause potentially outweighs the risks. And according to the FDA, women 65 years or older may have an increased risk of dementia associated with hormone medication use. For women who have not undergone a hysterectomy, estrogen-only medications may raise the likelihood of developing cancer of the uterine lining, also known as endometrial cancer, necessitating use of progestin to prevent it.

The specific type and dose of hormones, as well as personal health history and risk factors, should be carefully considered when determining the appropriateness of hormone replacement therapy.

Fezolinetant (Veozah)

"Hormone therapy is still the best medicine for hot flashes, but if you are not a good candidate for this medication, we are soon going to have a new medicine that is much more specifically targeting hot flashes with fewer side effects than previous options,"said Dr. Rebecca Dunsmoor-Su, co-medical director at Seattle Clinical Research Center and director of menopause at the Swedish Women's Clinic in Seattle.

Veozah is a menopause medication recently approved by the FDA to treat moderate to severe hot flashes. It is the first neurokinin-3 receptor antagonist specifically designed to target the mechanism that triggers hot flashes in the brain.

By targeting the underlying mechanism of hot flashes, Veozah offers a promising approach to managing this common symptom and improving overall well-being.

Antidepressants

Addressing menopause symptoms often involves a multidimensional strategy, and antidepressants can help manage mood-related challenges during this transition. Here are some commonly prescribed antidepressant medications for menopause, according to the women's health foundation Susan G. Komen:

• Citalopram (Celexa)
• Escitalopram (Lexapro)
• Fluoxetine (Prozac)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

These medications, known as selective serotonin reuptake inhibitors (SSRIs), work by modulating serotonin levels in the brain, helping alleviate hot flashes and mood disturbances.

But these drugs have potential side effects, according to the Mayo Clinic. Common side effects include nausea, drowsiness and sexual dysfunction, which may vary among individuals and specific medications. Consult with your doctor to determine the most suitable antidepressant option and carefully weigh the benefits and potential risks.

Medications can help relieve hot flashes and vaginal dryness

Hormone therapy and antidepressants are standard treatment options for relieving menopause symptoms. Despite its potential risks, hormone therapy can effectively alleviate hot flashes, vaginal dryness and other menopausal discomforts, but careful consideration of individual health factors is necessary.

Antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs), can also relieve hot flashes for women who are unable to take hormone therapy.

SOURCE: Rebecca Dunsmoor-Su, MD, co-medical director, Seattle Clinical Research Center, and director of menopause, Swedish Women's Clinic, Seattle