Medically Reviewed by Samantha M. Dunham, MD on December 1, 2024 | Written by Progyny Editorial Team
Menopause is full of challenging symptoms like hot flashes, mood swings, vaginal dryness, and decreased sex drive. These symptoms can affect your overall well-being and interfere with your daily life. Fortunately, there are treatments available that can help.
In this article, we will present the available treatments and provide tips on how to check your insurance coverage. If you don’t have coverage, we will explain how to use coupons or assistance programs.
Prescription Medications for Menopause Symptoms
Menopause hormone therapy (MHT)
MHT is one of the most common treatments during menopause. It works by supplementing the hormones your body stops producing during menopause, like estrogen and progesterone.
Estrogen therapy
Estrogen therapy replenishes the estrogen levels that are lost during menopause. It is often used to manage vasomotor symptoms, like hot flashes and night sweats, and vaginal symptoms, like itching, dryness, and irritation.
Systemic estrogen therapy is available in oral tablets and non-oral forms, like a transdermal (skin) patch, gel, and spray. Plus, vaginal (local) estrogen as a cream, suppository, tablet, and ring.
Your doctor will determine if you are eligible for estrogen therapy based on many factors. You may not be a candidate for systemic MHT if you have a history of breast or uterine cancer, blood clots, stroke or heart attack, or other blood clotting disorders. You’re likely a candidate for vaginal (local) therapy as long as you do not take a medication called an aromatase inhibitor.
Estrogen-progesterone therapy (EPT)
If you have a uterus, progesterone needs to be taken in conjunction with estrogen because it helps protect the lining of your uterus. Progesterone is available in three forms:
- Skin patches in combination with estrogen
- IUD, a small device inserted into your uterus, off-label use
- Oral pills
Progesterone is not available as a skin cream.
Selective estrogen receptor modulator (Duavee)
A daily tablet that provides estrogen for symptom management and also protects the lining of the uterus. This medication also strengthens bones, reducing the risk of fractures.
Non-Hormonal Medications
Some treatments do not replace your hormone levels but work to reduce menopause symptoms. These treatments may be appropriate for you if you can’t or don’t want to take MHT.
The following medications have proven useful in the management of menopausal hot flashes/mood disorders. However, it’s important that you and your provider review your personal medical history and symptoms to understand which prescription option is best suited to your needs.
Medications to reduce hot flashes
Although some of these medications were not originally developed to treat hot flashes, they are now often prescribed off-label for this purpose due to their effectiveness. The following are a few treatment options:
- Fezolinetant: FDA-approved oral tablet that works on the body’s thermometer in the brain to reduce hot flashes and night sweats.
- Selective serotonin receptor inhibitors (SSRIs): Antidepressants used for individuals who cannot take estrogen. Commonly prescribed SSRIs include citalopram, escitalopram, and paroxetine.
- Serotonin-norepinephrine reuptake inhibitor (SNRI): Another type of antidepressant that works similarly to SSRIs. Commonly used medications in this class are venlafaxine and desvenlafaxine.
- Gabapentin: Works in the brain to treat seizures and to reduce pain; effective in reducing hot flashes and night sweats too.
- Oxybutynin: Typically used to treat an overactive bladder and can also reduce hot flashes and night sweats.
Medications to improve mood
Antidepressants and antianxiety medications can help treat depression and anxiety which often worsens in menopause.
Antidepression medications work by increasing serotonin and sometimes norepinephrine and dopamine in your brain. Commonly prescribed antidepression medications include:
- SSRIs: Citalopram, escitalopram, fluoxetine, paroxetine, sertraline
- SNRIs: Venlafaxine, desvenlafaxine, duloxetine
- Atypical antidepressants: Bupropion
Antianxiety medications work by supporting the neurochemistry of your brain. Commonly prescribed antianxiety medications include:
- Benzodiazepines: Alprazolam, clonazepam, lorazepam
- Antidepressants: SSRIs and SNRIS
- Beta-blockers (medications that relieve the physical feelings of anxiety)
- Buspirone
Osteoporosis Medications
Menopause increases the risk of osteoporosis due to the rapid decrease in bone density. Treatments to strengthen your bones and reduce your risk of fracture include:
- MHT: May be recommended for individuals within ten years of menopause or less than 60 years old. Replenishing estrogen levels decreases the rate of bone loss.
- Bisphosphonates: Recommended for individuals with high risk of fracture to treat osteoporosis.
- For severe osteoporosis there are bone-building medications like denosumab, teriparatide, and romosozumab are also used to treat osteoporosis and help reduce fracture risk.
Checking Insurance Coverage for Menopause Medications
If your doctor recommends a prescription medication to manage menopause symptoms, it’s important to understand the costs involved. Most insurance plans cover MHT, in some form. The price you will pay depends on your prescription coverage. Here’s how to check your coverage:
- Access your insurance provider’s website or app: From here you can log into your member portal. You’ll then be able to search for medications by name to discover if the medication is covered and how much you’ll pay out of pocket.
- Talk with your doctor or pharmacist: You can discuss your options with your healthcare provider or pharmacist to find the most affordable option for you. There may be a generic version of the medication or a copay assistance program to help lessen the cost.
What to Do if You Don’t Have Coverage
Savings programs
If you don’t have insurance coverage, or you find your insurance does not provide sufficient coverage, you may consider prescription savings programs. You can check out some of the available prescription discount services here:
Simply search for the medication and find the pharmacy with the lowest price. Ask your doctor to send the prescription into the pharmacy of your choice, and/or access your free coupon.
Manufacturer coupons
You may find digital coupons on the official manufacturer’s website, or you can ask your pharmacist for available manufacturer coupons.
Payment assistance programs
These programs are available to make prescription medications more affordable, even if you have insurance coverage.
- Payment assistance programs: These programs are provided by pharmaceutical companies to help eligible individuals access medications at little to no cost. Visit the drug manufacturer’s website to fill out an eligibility application.
- Copay assistance programs: If your copay is high with your insurance, drug manufacturers provide copay programs to reduce your out-of-pocket expense. Talk with your healthcare provider or pharmacist for available options.
Final Thoughts
Menopause can bring many challenging side effects, but there are treatments and medications that can help. Talk to your physician about what treatments may be appropriate for you.
Remember, taking proactive steps to manage your menopause symptoms can greatly improve your quality of life.