Menopause symptoms: what experts say can help

Canadian clinicians say hormone therapy is the standard treatment for hot flashes and night sweats, while non-hormonal drugs, exercise, diet and emerging GLP-1 research offer additional options. Suitability depends on individual health, and experts say more research is needed on some new drug combinations.

Clinicians and researchers in Canada described a range of options for people experiencing menopause symptoms, from hormone therapy to lifestyle changes and newer medications. Hormone therapy is cited as the gold standard for hot flashes and night sweats and can also ease insomnia, vaginal dryness and joint pain. Non-hormonal drugs, including neurokinin receptor antagonists approved in Canada, can reduce vasomotor symptoms for people who cannot use hormones. Experts also discussed exercise, diet and early studies on combining hormone therapy with GLP-1 weight-loss drugs. Key facts: - Hormone therapy delivered as a pill, patch or gel is described as the primary treatment for vasomotor symptoms and can address related issues such as sleep trouble and vaginal dryness. - Some people are not suitable for hormone therapy, including those with uncontrolled high blood pressure, heart disease or liver cirrhosis, and most breast cancer survivors are unlikely to qualify. - Non-hormonal options such as neurokinin receptor antagonists (for example, fezolinetant) have been shown to reduce hot flashes and night sweats; rare liver effects mean people with liver disease may not be candidates. - Exercise and diet affect bone density, muscle mass, heart health and weight; recommended routines cited include strength training three times a week and 150 minutes of moderate to vigorous activity weekly. - Early observational research reported greater weight loss and improved cardiometabolic outcomes when hormone therapy was used alongside GLP-1 drugs like tirzepatide, but experts say larger studies are needed and note possible muscle-mass loss with GLP-1s. Summary: Treatment choices span hormonal, non-hormonal and lifestyle approaches and can relieve common menopausal symptoms while also influencing bone, muscle and cardiometabolic health. Experts report that suitability varies with individual medical history and that more research is needed on interactions between hormone therapy and GLP-1 drugs. Undetermined at this time.