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Menopause - Management
How can I manage menopausal symptoms without HRT?
- Offer lifestyle advice to control symptoms; if this is not effective, consider other treatments.
- For vasomotor symptoms, consider:
- A trial (2 weeks) of paroxetine (20 mg daily), fluoxetine (20 mg daily), citalopram (20 mg daily), or venlafaxine 37.5 mg twice a day (unlicensed).
- A trial (2–4 weeks) of clonidine 50 to 75 micrograms twice a day (licensed use).
- A progestogen such as norethisterone or megestrol (both unlicensed). Seek specialist advice.
- For vaginal dryness, prescribe a vaginal lubricant or moisturizer, such as Replens MD®.
- Manage psychological symptoms, such as mood disturbances, anxiety, and depression on an individual basis. They may be addressed using self-help groups, psychotherapy, other forms of counselling, or antidepressants.
- CKS does not recommend the use of complementary therapies (e.g. soy, red clover, black cohosh).
In depth
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