Menopause & perimenopause treatment options

Perimenopause and menopause are a normal part of life’s rhythm for most women. But “normal” doesn’t always mean easy. If you’re dealing with sleepless nights from hot flashes, mood swings that leave you wiped, or intimacy that’s suddenly uncomfortable, you’re not imagining things. And you don’t have to white-knuckle your way through it.

If you’re experiencing disruptive symptoms like night sweats, hot flashes, lower libido, and vaginal dryness, there are safe, effective treatments that can help you feel more like yourself again. Your healthcare provider will typically first run blood tests to check your hormone levels and then walk you through potential treatment options tailored to your symptoms, health history, and what matters most to you. 

These can include hormone therapy that relies on estradiol, which improves symptoms for women who have had hysterectomies, as well as a combination of estrogen and progesterone therapies that can be taken in tablet, cream, and patch form. And if you feel hormone therapy isn’t right for you, non-hormone medications like antidepressants – such as selective serotonin reuptake inhibitors (SSRIs) – can help with hot flashes and night sweats, too. 

Does menopause require medical treatment?

Technically, no. Just like puberty or pregnancy, menopause is a natural biological shift and not a disease that needs “fixing.” Some women sail through it easily. However, for many others, symptoms like brain fog, sleep disruption, or vaginal dryness can really get in the way of daily life. 

Let’s be clear: there’s nothing heroic about suffering in silence. Seeking relief isn’t a weakness. It’s taking back control over your body and can make a real difference in your quality of life during this chapter.

Take a closer look at the wide range of menopause and perimenopause treatments available today that can actually make a difference in your symptoms.

Menopause hormone therapy (MHT)

One of the most trusted menopause therapies is menopause hormone therapy (MHT). It uses estrogen and progesterone to treat the uncomfortable symptoms that come with perimenopause and menopause. As a result, MHT can help cool down hot flashes, lift brain fog, and restore comfort during intimacy. 

MHT comes in many forms, including tablets, patches, creams, and gels. This range of options helps you find what fits your routine best. It’s also important to know that how soon MHT starts working can vary. However, most people start noticing improvement within a few weeks, but everyone’s timetable is different. 

Like any medication, MHT has benefits and risks. It’s important to have an open, honest discussion with your provider about your personal and family health history to help you make an informed choice.

Many insurance plans cover MHT. While QuickMD doesn’t take insurance directly, we offer straightforward, affordable cash-pay pricing so you’re never stuck guessing about the cost for treatment. 

Next, we’ll explore some of the most common types of MHT available to help you make the right choice for you. 

Vaginal estrogen

For localized symptoms like vaginal dryness, itching, or pain during sex, vaginal estrogen (sometimes called local estrogen therapy) can be a game-changer. Think of it like spot-treatment for your most sensitive tissues. It also helps address bladder problems, including UTIs and urinary frequency and urgency. 

Because it works right where you apply it, you usually don’t need to pair it with progesterone (which is required with systemic estrogen to protect the uterus). Relief often kicks in within 2 to 4 weeks.

It’s available as a cream, tablet, or flexible ring that lasts up to three months. Side effects are rare but can include mild breast tenderness, headaches, or nausea. These initial symptoms are typically milder than adjusting to full-body hormone therapy, but in both cases, they clear up once your body is used to them. 

Non-hormone medication treatments

Hormones aren’t your only path to relief. Several non-hormonal medications are FDA-approved or commonly used off-label to tackle specific symptoms:

• Hot flashes & night sweats: Low-dose SSRIs (like paroxetine) or gabapentin can help regulate your body’s thermostat.
• Vaginal dryness: Ospemifene is a pill that acts like estrogen only in vaginal tissue, helping restore elasticity and moisture.
• Mood swings & brain fog: Certain antidepressants may ease emotional ups-and-downs. They can even sharpen mental clarity for some.

Over-the-counter options like water-based lubricants (for intimacy) or herbal supplements (like black cohosh) are also popular. But tread carefully: supplements aren’t regulated by the FDA, so quality and effectiveness can vary widely. Always talk to your provider before starting anything new, even if it’s “natural.”

These treatments often take longer to work than MHT (think weeks, not days) and can have side effects, like drowsiness from gabapentin or digestive upset from supplements.

Your insurance may cover these medications, but there may be restrictions to be aware of, depending on your plan. 

Lifestyle and at-home remedies

Sometimes, the most powerful tools are already in your kitchen, closet, or daily routine. Small, consistent tweaks can stack up to big relief:

• Eat well: Load up on veggies, lean proteins, whole grains, and calcium-rich foods to support bone health. As Dr. Sheryl Ross (Dr. Sherry), Chief Medical Officer of Women’s Health at QuickMD, explains, “During menopause, you lose your source of estrogen, which helps to protect bones. So, this phase calls for extra reinforcements!” She also cautions to, “Avoid hot and spicy foods that can make hot flashes and night sweats worse.” 
• Move your body: Regular exercise can boost mood, sleep, and energy while helping manage weight. But don’t feel like you have to tap into your inner Arnold Schwarzenegger and start pumping iron. Gentle exercise like walking and yoga can help. So, body-weight exercises like Pilates or starting to lift light weights – or even taking a dance class – can be great ways to make movement fun and a regular part of your menopausal routine. Dr. Sherry recommends to “Aim for 150 minutes per week for optimal health.”
• Breathe & relax: Try deep breathing, meditation, or gentle stretching before bed. Stress can crank up hot flashes. Deep breathing and relaxing activities can help calm your nervous system and dial it down.
• Kick the habit: Smoking makes hot flashes worse. It also speeds bone loss. Not smoking is one of the best things you can do during this time of life. 
• Strengthen your pelvic floor: Kegels aren’t just for new moms. These vaginal exercises can ease urinary leaks and make sex more comfortable. Best of all, you can do them without anyone noticing while sitting at your desk or on the couch binge-watching your favorite show. 
• Stay cool: Dress in layers so you can stay comfortable and well-dressed, even if a hot flash strikes. Keep a portable fan nearby. Look for cooling bedsheets and keep temperatures optimum to make your bedroom a sleep sanctuary. Pajamas in natural fibers can also help you sleep more comfortably. 
• Get a good night’s sleep: Those breathable pajamas and cool air in your bedroom can help set the stage for a better night’s sleep. “Prioritizing adequate sleep supports physical, mental, and emotional focus, as well as your overall wellness,” notes Dr. Sherry. Getting a good night’s sleep is critical for physical and mental health. It’s recommended that an adult sleep 7 to 8 hours per night. 
• Stress less: Easier said than done, right? “Stress is an epidemic health concern for women and has a negative impact on overall health,” observes Dr. Sherry. It can contribute to physical problems like an increase in heart rate, blood pressure, weight gain, headaches, and gastrointestinal problems. Stress also plays a key role in emotional and psychological issues like depression, mood swings, anxiety, and brain fog. Many of the lifestyle changes recommended here can help you start to stamp out stress, including regular exercise, meditation, mindfulness, and deep breathing, getting a good night’s sleep and eating a healthy diet.
  

Making lifestyle adjustments can help you better manage your menopause symptoms. And don’t be shy about asking your healthcare provider for personalized tips and guidance. 

Alternative menopause treatment options

Many women explore complementary approaches to feel more in control when perimenopause and menopause strike. While research is still evolving, some options show promise:

• Yoga: Reduces stress, improves sleep, and may ease hot flashes through breath and mindful movement.
• Acupuncture: Some studies suggest it can lower hot flash frequency, possibly by calming the nervous system.
• Vitamins: D for bones and mood; B6 and B12 for energy and nerve health. (Get your levels checked before mega-dosing!)
• Herbs: Black cohosh, maca, St. John’s wort, and valerian are some herbal supplements widely used, but evidence is mixed. Before starting any herbal supplements, check with your provider to make sure they don’t conflict with any other medications you take. 
• Hypnosis: Emerging research shows clinical hypnosis can reduce hot flashes by approximately 72% in some women, likely by changing how the brain processes temperature signals.
  

Before choosing a natural treatment for menopause, keep in mind that the FDA doesn’t regulate these supplements. They might be effective, but results can vary from person to person. 

Explore menopause treatment options with QuickMD

You don’t have to “tough out” the uncomfortable symptoms that come with perimenopause and menopause. Here at QuickMD, we meet you where you are. Whether you’re curious about hormone therapy, need help weighing risks, or just want a judgment-free space to ask, “Is this normal?, we’ve got you. Our licensed providers specialize in menopause care and work with you to create a plan that works for you. 

With our online menopause treatment guidance, you can receive comprehensive, personalized care at your convenience, from the comforts of home.