Estrogen only: Preferred for women who underwent hysterectomy. May be applied either orally or transdermally.
Estrogen + progesterone: Women with their uterus should receive both estrogen and progesterone to prevent endometrial hyperplasia. For women at their perimenopausal period, cyclic treatment is preferred. For women at menopause for more than 1 year, continuous treatment is preferred. Progesterone may be applied orally, vaginally or locally.
Androgens: Loss of libido has been related to decreased androgen secretion by the ovaries during menopause. Thus, androgen replacement has been an option for menopause. Excessive androgen replacement may cause hirsutism.
Tibolone: The molecule binds to estrogen, progesterone and androgen receptors. It does not cause vaginal bleeding. Increased breast cancer risk is related to estrogen and thus tibolone does not increase the risk very much.
Phytoestrogens: Includes black cohosh and isoflavin. They have weak estrogenic activity. Although some studies showed amelioration of night sweats or vaginal dryness, not every study gave the same result. Phytoestrogens are beneficial for those who can not receive estrogens.
Antidepressants: They are weaker than estrogen and stronger than placebo to relieve menopausal symptoms.
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