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Prescription medications for menopause
Women are frequently prescribed medications for perimenopause and menopause symptoms without context, alternatives, or honest odds. Rose covers the full landscape — what each medication is, what the evidence shows, and the questions worth asking your doctor.
Important
This section is educational — not medical advice. Prescription medications require a prescriber who knows your full medical history. Rose gives you the information to have an informed conversation. Your doctor makes the recommendation for you specifically.
Rose
"The most common thing I kept seeing in my research — women being offered one medication with no context about alternatives. Or being offered nothing at all. Both happened to me. This section exists so you walk into your appointment knowing what to ask for."
Hormone therapy
Strong evidence
Systemic HRT (Estrogen + Progesterone)
The most evidence-backed treatment available for menopause symptoms.
Hormone therapy
Strong evidence
Local Vaginal Estrogen
Highly effective for vaginal and urinary symptoms. Minimal systemic absorption. Vastly underused.
Antidepressants
Mixed evidence
SSRIs and SNRIs
Commonly prescribed for menopause — but often not the right first choice.
Anticonvulsant
Mixed evidence
Gabapentin (Neurontin)
Modestly effective for hot flashes. Significant side effects limit its appeal.
SERM
Strong evidence
Ospemifene (Osphena)
An oral non-hormonal tablet for painful sex and vaginal dryness. Most women have never heard of it.
Off-label
Mixed evidence
Low-Dose Naltrexone (LDN)
Growing evidence and strong community interest. Honest about where the research is.
Blood pressure medication
Weak evidence
Clonidine (Catapres)
Older option with weak evidence. Rarely the right choice today.
A word from Rose
"You are allowed to ask for a second opinion. You are allowed to ask why one medication was chosen over another. You are allowed to say you want to discuss HRT before starting an antidepressant. You are allowed to advocate for yourself in every appointment. That is not being difficult — that is being your own best advocate."