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What people try for menopause, explained simply

By Ellum EditorialUpdated AI use

The short answer

Menopause is a normal change in a woman's life when her period stops. It often happens between ages 45 and 55.[6] One of the 5 we list is FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause: Estradiol. DHEA (prasterone) is also FDA-approved, but only in a narrower way: for moderate to severe pain during sex caused by menopause. It is approved only as a prescription vaginal insert, not as a supplement. FDA has also approved other drugs, not on this page, for moderate to severe hot flashes from menopause. All 5 options people try for menopause are in the Sex hormones group.

  • What studies found

    We have not yet summarized what studies found for these options, so this page does not compare how well they work.

  • How you get them

    • Prescription from a doctor: 2
    • A prescription medicine, approved for other uses: 2
    • Sold without a prescription: 1

See all 5 options

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FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause: 2 of 5

One square for each of the 5 options, grouped by its status for this goal.

  • 1FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause
  • 1FDA-approved for moderate to severe pain during sex caused by menopause (vaginal insert only)
  • 2Approved for other uses
  • 1Supplement
See the numbers as a table
The 5 options by status
StatusOptions
FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause1
FDA-approved for moderate to severe pain during sex caused by menopause (vaginal insert only)1
Approved for other uses2
Supplement1
  1. Ellum Peptide Access Index

Status as of

What people try

Each group is one kind of option. An option can be in more than one group.

  • Sex hormones (5)

Warnings on the label

From the Climara prescribing information (FDA label):[2]

Boxed warning (FDA's strongest warning): estrogen without a progestogen raises the risk of cancer of the uterine lining in women with a uterus; in large studies of women after menopause, estrogen alone raised the risk of stroke and blood clots, estrogen plus progestin raised the risk of blood clots, stroke, heart attack and invasive breast cancer, and both raised the risk of probable dementia in older women; estrogens should not be used to prevent heart and blood vessel disease or dementia; the studies used one oral estrogen, and the label says these risks cannot be ruled out for other estrogen products.

  • a higher risk of stroke and blood clots, and with a progestin also heart attack; stop it at once if any of these happens or is suspected
  • cancer: a higher risk of cancer of the uterine lining with estrogen alone in women with a uterus; a higher risk of breast cancer, greater with estrogen plus progestin and smaller with estrogen alone after several years of use; and a higher risk of ovarian cancer
  • a higher risk of probable dementia, found in older women
  • a higher risk of gallbladder disease needing surgery
  • very high blood calcium in women with breast cancer that has spread to the bones
  • blood clots in the retina of the eye; stop it and get checked for sudden vision loss, bulging eyes, double vision or migraine
  • for women with a uterus, adding a progestogen lowers the chance of overgrowth of the uterine lining, but may bring its own risks, including a higher risk of breast cancer
  • rarely, a large rise in blood pressure
  • in women with high triglycerides, a further rise that can lead to pancreatitis
  • the body may break down estrogen poorly in women with liver problems; caution for women with past jaundice from estrogen or pregnancy, and stop it if that jaundice comes back
  • women taking thyroid hormone may need a higher dose and should have their thyroid checked
  • fluid build-up, a concern for women with heart or kidney problems
  • low blood calcium in women with hypoparathyroidism
  • rarely, leftover endometriosis turning cancerous in women given estrogen alone after a hysterectomy
  • worse swelling attacks in women with hereditary angioedema
  • worse asthma, diabetes, epilepsy, migraine, porphyria, lupus or liver hemangiomas
  • blood levels of FSH and estradiol have not been shown to help manage hot flashes or vaginal symptoms of menopause
  • changed results on some blood tests, including clotting, thyroid, hormone-binding protein and cholesterol tests

From the Intrarosa prescribing information (FDA label):[3]

  • the body turns prasterone into estrogen, and estrogen must not be used by women who have had or may have had breast cancer; the insert has not been studied in women with a history of breast cancer

How to get them

One of the 5 we list is FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause: Estradiol. DHEA (prasterone) is also FDA-approved, but only in a narrower way: for moderate to severe pain during sex caused by menopause. It is approved only as a prescription vaginal insert, not as a supplement. FDA has also approved other drugs, not on this page, for moderate to severe hot flashes from menopause. They include fezolinetant (Veozah) and elinzanetant (Lynkuet), which are not hormones.[4–5]

  • FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause (1): Prescription from a doctor
  • FDA-approved for moderate to severe pain during sex caused by menopause (vaginal insert only) (1): Prescription from a doctor
  • Approved for other uses (2): A prescription medicine, approved for other uses
  • Supplement (1): Sold without a prescription

Cost

No price shown for Estradiol and DHEA (prasterone) on this page. This page shows no seller prices or seller links.

All options

Every option, one card each

Estradiol

The main human estrogen, used as hormone replacement.

FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause: Yes

For women with moderate to severe hot flashes (vasomotor symptoms) or moderate to severe symptoms of vaginal and vulvar thinning and dryness (atrophy) from menopause; for vaginal symptoms alone, the label says to consider a vaginal product first. This label is for an estradiol skin patch

How you get it: Prescription from a doctor

Read the FDA label

DHEA (prasterone)

FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause: only in a narrower way

For moderate to severe pain during sex caused by menopause. It is approved only as a prescription vaginal insert, not as a supplement

How you get it: Prescription from a doctor

Read the FDA label

Supplement (1)

FDA-approved for moderate to severe hot flashes or vaginal symptoms of menopause: No

How you get it: Sold without a prescription

The research

What this doesn’t establish

Nothing on this page shows that any option helps menopause symptoms in a way FDA has not approved.

A status shows where something stands with FDA, not whether it works or is safe for you. Being listed here isn’t a recommendation.

References

  1. Ellum Peptide Access Index
  2. Climara prescribing information (FDA label)
  3. Intrarosa prescribing information (FDA label)
  4. Veozah prescribing information (FDA label)
  5. Lynkuet prescribing information (FDA label)
  6. FDA: menopause