What is the first treatment tried for menopause?

Menopause can bring hot flushes, night sweats, sleep difficulty, mood changes, vaginal dryness and urinary discomfort. Treatment is selected after discussing symptoms, periods, medical history, medicines and personal risk factors. [Menopause](/conditions/menopause/) gives background on these changes.

Hormone Replacement Therapy can replace oestrogen, with a progestogen added when needed to protect the womb lining. Vaginal oestrogen focuses on local vaginal or urinary symptoms and is different from whole-body therapy. Non-hormonal treatment may suit people who cannot use hormones or prefer another approach.

Keep a brief record of the symptoms that disturb sleep, work, sex or daily activities. Take your medication history to the appointment and mention migraine, blood clots, liver disease, unexplained bleeding or a history of hormone-sensitive cancer.

Discuss treatment goals and review timing. Testosterone therapy for women is a specialist option for selected sexual symptoms after other causes have been considered, rather than a general treatment for every menopause symptom.

Seek medical assessment for bleeding after menopause, bleeding that is unusually heavy or persistent, a new breast change, chest pain, breathlessness, or a painful swollen leg. Get urgent help for sudden weakness, severe headache or difficulty speaking.

Ask which symptom is being treated, whether hormones are suitable, what alternatives exist, how long to try the plan, and which bleeding or other effects need review.