Symptoms associated with the menopause
As well as a change in their menstrual cycle women may experience a variety of symptoms associated with menopause, including:
Managing short-term menopausal symptoms
The information below is not intended for women with premature ovarian
Offer women Hormone Replacement Therapy (HRT) for vasomotor symptoms after discussing with them the short-term (up to 5 years) and longer-term benefits and risks. Offer a choice of preparations as follows:
HRT can also help to alleviate low mood that arises as a result of the menopause.
Altered sexual function
Consider testosterone supplementation for menopausal women with low sexual desire if HRT alone is not effective.
Offer vaginal oestrogen to women with urogenital atrophy (including those on systemic HRT) and continue treatment for as long as needed to relieve symptoms.
Consider vaginal oestrogen for women with urogenital atrophy in whom systemic HRT is contraindicated, after seeking advice from a healthcare professional with expertise in menopause.
If vaginal oestrogen does not relieve symptoms of urogenital atrophy, consider increasing the dose after seeking advice from a healthcare professional with expertise in menopause.
Explain to women with urogenital atrophy that:
Advise women with vaginal dryness that moisturisers and lubricants can be used alone or in addition to vaginal oestrogen.
Explain to women who wish to try complementary therapies that the quality, purity and constituents of products may be unknown and the efficacy and safety of unregulated compounded bioidentical hormones are also unknown.
Starting and stopping HRT
Explain to women with a uterus that unscheduled vaginal bleeding is a common side effect of HRT within the first 3 months of treatment, but should be reported at the 3-month review appointment, or promptly if it occurs after the first 3 months of treatment.
Offer women who are stopping HRT a choice of gradually reducing or immediately stopping treatment. Explain to women that:
Long-term benefits and risks of HRT
Discuss with women the importance of keeping up to date with nationally recommended health screening.
Explain to women the risks relating to:
NICE. Menopause: diagnosis and management. Nice Guideline NG23. National Institute for Health Care and Excellence 2015 (updated Dec 2019)
This page is intended for UK healthcare professionals only
UK19NNM00001 March 2020