Non-hormonal treatments for menopausal symptoms

#### What you need to know Menopause is a normal event, and most women do not seek medical intervention. Of those who do, some will require only information and advice, but around 25% have problematic symptoms that may need treatment. Vasomotor symptoms are the main reason that women seek treatment. Hormone replacement therapy is effective for vasomotor symptoms, but for some it is unsuitable (due to preference or contraindications) and non-hormonal treatments can be considered. This update provides an overview of the evidence supporting non-hormonal treatments for vasomotor and vaginal symptoms, and translates this into practical guidance on managing these symptoms in clinical practice. The menopause is the final menstrual period. The “perimenopause” or “menopause transition” is the time from the onset of menstrual cycle changes until one year after the final menstrual period.1 Changes in vaginal bleeding patterns and vasomotor symptoms characterise the menopause transition, but the overall experience is highly variable and may be influenced by psychological, social, and cultural factors.2 Common symptoms include hot flushes and night sweats (vasomotor symptoms) and genital symptoms (vaginal dryness, dyspareunia), which may be accompanied by mood and sleep disturbance.3 …