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It is well known that Hormone Replacement Therapy, (HRT) can greatly improve the symptoms of menopause, indeed many individuals who have used HRT say it is life-changing or has simply given them their lives back. However, not everyone can take HRT and for those individuals, it can feel like they will simply have to suffer or put up with their symptoms.
Who can't use HRT?
There is a group of individuals who are not recommended to use HRT - those are often individuals who have had Hormone Dependent Breast Cancer in the past and by taking HRT may be at an increased risk of re-developing breast cancer.
The advice around Hormone Dependent Breast Cancer may change in the future as there are many studies happening worldwide which may refute this, however, as things stand the advice is to avoid HRT for these individuals.
The good news is there is hope for those individuals and some light at the end of the tunnel. Alternative or complementary therapies are available which may offer some relief but there are also some prescribed, non-hormonal based medications that can be obtained through the GP or specialist menopause clinic.
If you have access to myTamarin menopause support, book in a 1-1 session with one of our experts so you can discuss the options available to you, or ask a question to the expert privately or in a support group in the app.
What are my options for medication if I can't take HRT?
The medication we will discuss today is Clonidine; Selective Serotonin/Noradrenalin Reuptake Inhibitors, (SSRIs/SNRIs); Gabapentin.
Clonidine
This medication is known as a “Vasodilator” meaning it makes the blood vessels expand to allow blood to flow more easily. It is often used to treat high blood pressure and can be used to treat Migraines. As a Menopause treatment, it can help relieve hot flushes and night sweats.
It can take up to a month to feel relief from the symptoms and the medication can be taken for as long as it is needed. Side effects can include low blood pressure, tiredness and constipation.
Selective Serotonin/Noradrenalin Reuptake Inhibitors, (SSRIs/SNRIs)
Both groups of drugs are widely used antidepressants. It is believed they work by increasing the body’s natural Serotonin levels.
SSRI medications include Fluoxetine, (Prozac); Paroxetine, (Seroxat); Citalopram, (Cipramil); Escitalopram, (Ciprolex); Sertraline, (Lustral). SNRI medications include: Duloxetine, (Cymbalta and Yentreve); Venlafaxine, (Efexor).
National Institute for Clinical Excellence, (NICE) states antidepressants should not be used as the primary treatment of mood-related symptoms in menopause. However, studies show they can provide some relief with hot flushes and night sweats in low doses. Side effects can include dry mouth and low libido.
Gabapentin
This medication is typically used in the treatment of Epilepsy. It can be used to treat neuropathic pain like Migraines. Studies have shown it can help relieve hot flushes and night sweats in menopause. Side effects can include drowsiness and dizziness.
Things to remember with prescribed medication
All these medications are prescription, only and should be taken as advised by the prescriber. The medication should not be shared with others and all medications should be reviewed yearly with the prescriber.
Whether the choice is made not to take HRT or whether past health concerns negate the use of hormonal medication does not mean individuals have to suffer troublesome menopausal symptoms. It is important to speak with a menopause specialist practitioner and discuss all alternative treatment options be it complementary therapies, lifestyle changes, Cognitive Behavioural Therapy or alternative, prescribed medication, there should be a treatment to suit the needs of the individual.
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