Experiencing menopause symptoms? Here’s what experts can do to help
diet27:31What’s new in menopause treatment?
Dr. Alison Shea says that while menopause symptoms range from sleep problems to burning mouth syndrome, people aren’t always sure what they’re experiencing.
So The Dose spoke to several physicians and researchers at the forefront of menopause care in Canada about the latest treatments from hormone therapy to exercise and diet.
Here’s what they told us.
hormone therapy
hormone therapy Dr. Kelsey Mills, an obstetrician and gynecologist based in Victoria, BC, says delivery via pill, patch, or gel is considered the gold standard for anyone experiencing night sweats and hot flashes in menopause. Therapy can also help symptoms that include insomnia, joint pain, vaginal dryness, vaginal irritation, and pain during penetrative sex.
But Mills said, while it’s a safe and effective treatment, it’s not right for everyone.
He said anyone suffering from uncontrolled blood pressure, heart disease or liver cirrhosis should consider alternatives. And breast cancer survivors are unlikely to qualify; Some studies have found an association between hormone therapy and an increased risk of breast cancer.
A recent report found that women experiencing menopause symptoms said their concerns were often minimized and ignored by doctors. These types of interactions are something advocates are trying to change.
Ideal candidates are those under the age of 60, or within 10 years of menopause, who have symptoms that have a major impact on their daily life. This means that many women in the early years of menopause are typically eligible; In Canada, the average age women undergo this transition – defined as one year without menstruation – is 51, According to the Menopause Foundation of CanadaHowever the spectrum spans from 45 to 55 years of age.
Hormone therapy may also be a first line of defense to treat the early symptoms of perimenopause, especially hot flashes.
The perimenopausal period usually occurs between 40 and 50When estrogen and progesterone levels begin to fluctuate. Other early symptoms may also appear, including mood swings, changes in libido or weight gain, or night sweats.
It’s about treating symptoms, not balancing hormones, “because hormones are everywhere in perimenopause,” said Shea, an associate professor of obstetrics and gynecology at McMaster University, who also sits on the board of directors of the Canadian Menopause Society.
non-hormonal route
For people who can’t — or don’t want to — use hormonal therapy, there are other safe and effective medications for some common symptoms, such as hot flashes and night sweats.
Dr. Michelle Jacobson says that non-hormonal options like neurokinin receptor antagonists, similar to estrogen, may interfere with the brain’s efforts to reduce sudden increases in body temperature, causing hot flashes and night sweats.
“They work at the same center in the brain where hot flashes occur,” said Jacobson, co-founder of Cowen Women’s Health and chief of obstetrics and gynecology at William Osler Health Network.
A 2024 study Found that phaseolinent – ​​one such drug approved by Health Canada for menopausal symptoms – had the same effect as hormone therapy in reducing vasomotor symptoms of menopause, including hot flashes and night sweats. In rare cases, medication May affect liver function Therefore anyone with cirrhosis or other liver problems cannot be a candidate.
lifestyle changes
The changes in hormone levels that accompany menopause can affect everything from bone density and muscle mass to heart health and weight gain. And some of those symptoms may improve by choosing healthy foods and exercising, Jacobson said.
Mills recommends at least 30 minutes of strength training three times a week, including 150 minutes of moderate to vigorous exercise, consistent with International Menopause Society Guidelines.
Jacobson cautions that there is little evidence that exercise can improve hot flashes, but she says weight loss may improve hot flashes for overweight women. And she said menopause is also linked to worsening cholesterol and triglyceride levels, worsening insulin resistance – which increases the risk of type 2 diabetes – and weight gain.
white coat black art26:30The rise of paid menopause care
Overwhelmed by hot flashes, brain fog and a frozen shoulder, Aidan Brame turned to a private clinic when the public system couldn’t help. Her experience highlights why more Canadians are paying for menopause care (https://menopausefoundationcanada.ca/pdf_files/How_Assess_Virtual_Private_Clinics_EN.pdf), and what it reveals about gaps in the health system.
“So exercise and weight loss may be helpful in improving your overall heart health and outcomes,” he said.
a healthy dietSuch as reducing how often you eat ultra-processed foods or adding more calcium in your diet According to Shea, it may help manage the loss of bone density during menopause.
GLP-1 drugs show potential
The connection between weight gain and menopause has prompted some research into the use of GLP-1 drugs to help with and without hormone therapy.
New studies show that combining hormone therapy with weight loss drugs — such as Monjaro and Zepbound — increased the amount of weight loss in participants.
One such paper, A 2026 observational study A study of 120 postmenopausal women published in The Lancet found that women who were taking hormone therapy with the GLP-1 drug tirazepate were associated with “greater weight loss and better cardiometabolic outcomes” compared with women not using hormone therapy.
A new study published in the journal Nature Medicine suggests that GLP-1 drugs like Ozempic and Vegovy may offer several other potential benefits beyond treating obesity, including reductions in drug and alcohol abuse and Alzheimer’s disease.
Still, Shea said more research is needed to better identify interactions between hormone therapy and GLP-1s.
“We need larger prospective studies to see what’s really happening,” he said, noting that GLP-1 drugs are linked. muscle lossSomething that may already be intensified during menopause.
Given the breadth of treatments available for menopause symptoms, all experts recommended consulting a physician or nurse practitioner to learn more.
