Menopause treatment questions
What are my menopause treatment options?
Talk with a HerDoc GP about HRT or menopausal hormone therapy (MHT), non-hormonal treatments and other ways of managing menopause symptoms.
What are my menopause treatment options?
Menopause treatment options include lifestyle and behavioural approaches, menopause-focused cognitive behavioural therapy (CBT), non-hormonal medicines and menopausal hormone therapy (MHT, also called HRT). The useful choice depends on your symptoms, health history, medicines, bleeding pattern, preferences and what improvement matters to you. A HerDoc GP can help compare options and plan safe follow-up; an examination, records, tests or specialist input may sometimes be needed.
HRT and MHT describe the same broad treatment
HRT means hormone replacement therapy. MHT means menopausal hormone therapy, which is the term commonly used in Australian menopause guidance. Both terms refer to hormone treatment used to manage menopause symptoms, although the exact treatment and its benefits and risks vary from person to person.
You do not need to know which form of treatment you want before the appointment. You can ask a specific HRT or MHT question, or talk through the symptoms affecting you and ask the GP to explain the options.
Begin with the symptoms you want help with
Treatment decisions begin with what you are experiencing. HRT or MHT may be considered for symptoms such as hot flushes, night sweats, sleep changes, mood changes or vaginal symptoms, but the GP will consider the whole picture rather than one symptom in isolation.
Have a few details handy about:
- which symptoms affect you most
- when they began and how often they occur
- your period and bleeding pattern
- current medicines, supplements and allergies
- previous treatment and how it affected you
- what you hope treatment may change
Your history shapes the benefit-risk discussion
The possible benefits and risks of MHT differ with the type of treatment, your age and timing, whether you have had a hysterectomy, and your personal and family medical history. The GP may ask about breast or uterine cancer, blood clots, stroke, heart health, migraines, bone health and any unexplained bleeding.
Potential benefits can include relief of hot flushes, night sweats and related sleep problems, as well as support for bone health. Possible risks include blood-clot, stroke and breast-health considerations. Your GP can explain how these issues apply to you without reducing the decision to one universal age rule.
Match the option to the symptom and your priorities
One treatment does not address every menopause concern. Match the discussion to the change you most want help with:
- For hot flushes and night sweats, compare hormonal and non-hormonal options and decide whether the goal is fewer episodes, less intense heat, better sleep or less disruption.
- For persistent insomnia, ask about sleep-specific assessment and cognitive behavioural therapy for insomnia (CBT-I) rather than assuming MHT will resolve every sleep problem.
- For vaginal dryness or painful sex, ask for a focused assessment and discussion of local options; hot-flush treatment may not address these symptoms.
- For weight changes, aches or fatigue, consider other contributors and use the focused guides rather than treating every midlife change as one hormonal problem.
MHT is not contraception, and it is not a weight-loss treatment. Compare each option against your health history, possible unwanted effects, other medicines, pregnancy-prevention needs and preferences. Agree on what improvement would count and when to review it. If an option is not helping or no longer fits your priorities, ask to reconsider the plan rather than continuing indefinitely.
Explore your main concern
Choose a focused guide for more detail:
Compare hormonal and non-hormonal options
A HerDoc GP can assess your symptoms and health history, discuss options and help plan follow-up. An examination, records, tests or specialist advice may be needed. You can ask about starting treatment, review an existing treatment or compare other options.
For hot flushes and night sweats, non-hormonal options include medicines, menopause-focused cognitive behavioural therapy (CBT) and clinical hypnosis. These are options to discuss if you prefer not to use hormones or hormone treatment may not fit your health history. The alternatives depend on the symptom you want help with.
Menopause-focused CBT can help reduce the distress and disruption caused by hot flushes and night sweats. Clinical hypnosis uses focused attention, imagery and suggestion in a structured programme; research has found benefits for hot flushes, but results vary. Ask about the practitioner’s training, what the programme involves and the evidence supporting that approach.
Your GP can help you compare options. If a structured therapy is recommended, ask who will deliver it and how to access it. Useful questions include:
- what improvement to look for: fewer flushes, better sleep or less disruption
- how the option fits your health history and current medicines
- what appointments or home practice are involved and any separate costs
- when to review progress and what to do if it is not helping
How will I know whether treatment is helping?
Agree on the outcome before starting: for example, fewer or less intense flushes, better sleep, less vaginal discomfort, improved mood or easier daily function. Keep a simple record if it helps, but do not feel required to track every symptom. Improvement can be gradual, and different symptoms may respond at different times.
For MHT, Australian Government guidance recommends an initial follow-up around 6 to 12 weeks after starting. The useful timing for another treatment depends on the option, the expected response, your health history and any side effects. Later reviews should revisit benefits, unwanted effects, bleeding, medicines, new health information and whether the treatment still fits your priorities.
If there is little improvement, check whether enough time has passed to assess that option and whether the original symptom has another contributor. Persistent insomnia may need sleep-specific care; fatigue, pain, mood or bleeding may need their own assessment. A clinician can reconsider the diagnosis, how the treatment is being used, another option or a referral. Do not increase, stop or switch a prescribed treatment without discussing a safe plan.
Blood tests are not required before every menopause treatment decision or follow-up. They are useful when a result will clarify the diagnosis, assess another cause or monitor a treatment or health condition. Ask what each test will change.
What if I have side effects or bleeding?
Nausea, bloating, breast tenderness, headache, fluid retention or irregular bleeding can occur with MHT and may settle, but they still belong in the follow-up discussion. Contact the prescribing clinician earlier if an effect is difficult, worsening or makes treatment unacceptable. Review can consider timing, another cause, interactions and whether the plan should change; do not adjust a prescribed dose on your own.
Some prescribed cyclical treatment plans are expected to produce a scheduled withdrawal bleed. Ask what pattern is expected for your plan and seek assessment when bleeding falls outside that pattern, as described below.
Sources and further reading
Sources supporting this guide. Source organisations have not reviewed or endorsed HerDoc.
- NHS: things you can do during menopause
- The Menopause Society: appropriate uses of hormone therapy
- Sleep Health Foundation: menopause and sleep
- Healthdirect: menopausal hormone therapy
- Australasian Menopause Society: bleeding in perimenopause, after menopause and on MHT
- Healthdirect: vaginal bleeding
- Healthdirect: pulmonary embolism
- Australian Government: menopause treatment options
- North American Menopause Society: 2023 non-hormonal treatments for hot flushes and night sweats (abstract)
- Research: clinical hypnosis trial for hot flushes
When to seek urgent care
Arrange prompt medical assessment for heavy, prolonged or unexpected bleeding, bleeding after sex, bleeding after 12 months without a natural period that is not the scheduled withdrawal bleed expected with your prescribed plan, bleeding that starts after a no-bleeding pattern was established, a new breast or pelvic concern, or another symptom that needs examination. New pain, redness or swelling in one leg needs urgent local assessment. Call 000 for chest pain, new unexplained shortness of breath, coughing up a large amount of blood, coughing up blood with chest pain or breathlessness, fainting, sudden facial droop, sudden weakness or speech difficulty because these can be signs of a pulmonary embolism, heart attack or stroke. Call 000 for very heavy bleeding with faintness or collapse. Seek advice rather than waiting for a routine treatment review.
- Heavy, prolonged or unexpected bleeding
- New pain, redness or swelling in one leg
- Possible pulmonary embolism, heart attack or stroke symptoms
Related pages
FAQs
What should I ask about HRT or MHT?
Ask how menopausal hormone therapy (MHT, also called HRT) may help the symptoms that matter to you, which benefits and risks apply to your health history, what alternatives are available and how progress or side effects would be reviewed. An examination, records, tests or specialist advice may be needed.
Are HRT and MHT the same thing?
Yes. HRT means hormone replacement therapy, while MHT means menopausal hormone therapy. Australian menopause guidance commonly uses MHT, but many patients know the treatment as HRT.
Can I discuss HRT if I am in perimenopause?
Yes. You can discuss HRT or MHT questions during perimenopause, including symptoms, period changes, contraception needs and what you hope to improve. The GP will consider your stage of life and broader health before discussing an individual treatment decision.
What menopause symptoms may HRT help with?
HRT or MHT may be considered for symptoms such as hot flushes, night sweats, sleep disruption, mood changes or vaginal symptoms. Whether it fits your situation depends on which symptoms affect you, your health history and the balance of possible benefits and risks.
What will the GP ask before deciding whether to prescribe HRT?
The GP may ask about symptoms, period and bleeding history, current medicines, allergies, previous treatment and your personal and family medical history. They may also ask about breast or uterine cancer, blood clots, stroke, heart health, migraines, bone health and your treatment preferences.
Can I discuss my current medicines and possible interactions?
Yes. Have your medicines and supplements handy, including anything recently started or stopped. The GP can consider whether a medicine may affect your symptoms or needs to be considered when discussing treatment options.
Do I need blood tests before starting menopause treatment?
Not always. Many menopause treatment discussions begin with symptoms, age, period pattern and medical history rather than routine hormone tests. A GP may recommend testing when another cause is possible or when a result would affect the next step.
Can the GP explain the possible benefits and risks?
Yes. The GP can discuss possible symptom relief and bone-health benefits alongside blood-clot, stroke, breast-health and other considerations. The balance varies with the type and timing of treatment and your individual health history.
What non-hormonal options can I discuss?
You can compare behavioural approaches, menopause-focused cognitive behavioural therapy (CBT), clinical hypnosis and non-hormonal medicines where relevant to the symptom you want help with. Ask about expected benefits and limitations, possible side effects, who would deliver a structured therapy and how progress would be reviewed.
Can menopause treatment be decided during the first consultation?
The next step depends on the assessment. The GP may discuss an option and follow-up plan, or may need records, tests, an examination or specialist advice before deciding what care is appropriate.
Can menopause treatment take more than one consultation to discuss?
Yes. More than one conversation may be useful when you have several symptoms or questions, records need to be reviewed, or an examination or test would add information. Ask the GP what needs to happen before the next decision.
What follow-up may be needed after a treatment decision?
Follow-up depends on the treatment, your health history, symptoms and the plan you make with the doctor. The doctor may suggest continuing care or another consultation to review how you are going. Each HerDoc consultation has its own fee.
What if HRT is not right for me?
The alternatives depend on the symptom you want help with. For hot flushes and night sweats, options include non-hormonal medicines, menopause-focused CBT and clinical hypnosis. Your GP can help you compare these against your health history and preferences; other symptoms may need a different approach.
When do menopause symptoms need a face-to-face examination?
Face-to-face assessment may be needed for postmenopausal bleeding, very heavy or frequent bleeding, a breast or pelvic concern, or another symptom that cannot be adequately assessed online. The GP can explain what needs to be examined and how promptly.
What does a menopause treatment-question consultation cost?
An eligible standard HerDoc consultation is bulk billed at $0 with no gap. A private standard consultation costs $49 AUD and a private long consultation costs $95 AUD. A new menopause patient will usually benefit from a long appointment, particularly when there are several symptoms, treatment options or health-history questions to cover. Each later HerDoc appointment is booked separately. Eligible standard follow-up appointments can be bulk billed at $0 with no gap; otherwise, private fees apply.