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Medications to Manage Perimenopausal Symptoms

NYU Langone providers, which include the team at the Center for Midlife Health and Menopause, may recommend hormonal or nonhormonal medications to manage bothersome symptoms of perimenopause that can arise as the level of estrogen in the blood fluctuates.

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If you are experiencing hot flashes, night sweats, insomnia, mood swings, bone loss, or vaginal dryness, your provider may prescribe hormone therapy to address these symptoms.

Hormonal Medications

Based on the latest research, our providers understand the absolute health risk of hormone therapy to be very low. For patients using hormone therapy within 10 years of menopause or who are less than 60 years old, the benefits often outweigh the risks. Our specialists thoroughly evaluate each patient’s medical history before prescribing hormone therapy.

Estrogen and Progestogen Hormone Therapy

People who still have a uterus are prescribed estrogen along with a progestogen to protect the uterine lining. Estrogen and progestogens are available in many different forms, and the modes of delivery are tailored to each patient’s preferences and safety needs.

Estrogen-Only Hormone Therapy

Women who have had a hysterectomy, a surgical procedure to remove the uterus, can take estrogen alone. Research has demonstrated that one type of estrogen-only hormone therapy for people in menopause decreases the rate of breast cancer.

Estrogen can be given in a systemic form to treat symptoms of perimenopause or as a topical vaginal medication to treat symptoms of menopausal genitourinary syndrome. Vaginal estrogen is extremely safe.

Selective Estrogen Receptor Modulators

Your provider may prescribe selective estrogen receptor modulators if you are experiencing vaginal dryness or atrophy, a thinning and inflammation of the vaginal walls that’s caused by a reduction in the body’s estrogen levels. The condition can result in painful sexual intercourse. Taken by mouth, these medications, which do not contain estrogen, can repair and rebuild vaginal tissue.

Dehydroepiandrosterone Hormone Therapy

Dehydroepiandrosterone (DHEA) is a hormone made by the adrenal glands that influences estrogen production. Your provider may prescribe DHEA as a nightly vaginal suppository to help reduce vaginal dryness and atrophy and to relieve painful sex.

Nonhormonal Medications

Nonhormonal medications may be an option for people who cannot or choose not to take hormone therapy.

Nonhormonal medications include selective serotonin reuptake inhibitors and serotonin and norepinephrine reuptake inhibitors, which may reduce hot flashes and nights sweats. In addition, nonhormonal vaginal moisturizers may help to relieve vaginal dryness.

Our providers also offer integrative and psychological support services for people in perimenopause or menopause.

Our Research and Education in Menopause

Learn more about our research and professional education opportunities.