Menopause Medications

Duavee is a combination medication containing conjugated estrogens and bazedoxifene, a selective estrogen receptor modulator (SERM). FDA-approved for treatment of moderate to severe vasomotor symptoms associated with menopause and prevention of postmenopausal osteoporosis.

Bupropion is an atypical antidepressant FDA-approved for depression and smoking cessation but often prescribed off-label for managing mood symptoms and low sexual desire during menopause, as it is less likely to cause sexual side effects compared to other antidepressants.

Citalopram is a selective serotonin reuptake inhibitor (SSRI) FDA-approved for depression but commonly prescribed off-label for managing hot flashes during menopause, with demonstrated efficacy in clinical trials particularly for women who cannot take hormone therapy.

Clonidine is an alpha-2 adrenergic agonist FDA-approved for hypertension but commonly prescribed off-label for management of hot flashes in women who cannot use hormone therapy. Available as oral tablets and transdermal patches.

Compounded bioidentical hormone therapy involves custom-prepared hormone formulations made by specialized pharmacies. While individual hormone components may be FDA-approved, specific compounded formulations are not FDA-approved and lack the same regulatory oversight as commercial products.

Prempro is a combination hormone therapy containing conjugated estrogens and medroxyprogesterone acetate. FDA-approved for treatment of moderate to severe vasomotor symptoms associated with menopause, treatment of vulvar and vaginal atrophy, and prevention of postmenopausal osteoporosis.

Conjugated estrogens are a mixture of estrogen hormones extracted from pregnant mares' urine or synthesized from plant sources. FDA-approved to treat moderate to severe vasomotor symptoms of menopause, vulvar and vaginal atrophy, and to prevent osteoporosis.

Premarin Vaginal Cream is a local estrogen therapy containing conjugated estrogens derived from pregnant mares' urine. FDA-approved for the treatment of atrophic vaginitis and kraurosis vulvae associated with menopause.

Desvenlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant that is FDA-approved for treatment of major depressive disorder but is frequently prescribed off-label for the management of hot flashes and other vasomotor symptoms of menopause.

Drospirenone is a progestin-only oral contraceptive pill that is FDA-approved for pregnancy prevention but often prescribed off-label for perimenopausal women to help regulate cycles and manage some symptoms of the menopause transition.

Escitalopram is a selective serotonin reuptake inhibitor (SSRI) FDA-approved for depression and anxiety disorders but frequently prescribed off-label for managing hot flashes and mood symptoms during menopause, particularly for women who cannot take hormone therapy.

Nextstellis is a novel combined oral contraceptive containing estetrol, a native estrogen with selective activity, and drospirenone. While FDA-approved for contraception, it may be prescribed off-label to manage perimenopausal symptoms in appropriate candidates.

Femring is a vaginal ring that releases estradiol acetate continuously for 3 months. FDA-approved for the treatment of moderate to severe vasomotor symptoms and vulvar and vaginal atrophy associated with menopause.

Estradiol gel is a transdermal hormone therapy that delivers estradiol through the skin. FDA-approved for the treatment of moderate to severe vasomotor symptoms (hot flashes) associated with menopause, with the convenience of topical application.

Climara Pro is a combination hormone therapy patch containing estradiol and levonorgestrel (a progestin). FDA-approved for treatment of moderate to severe vasomotor symptoms associated with menopause and for the prevention of postmenopausal osteoporosis in women with an intact uterus.

CombiPatch is a combination hormone therapy patch containing estradiol and norethindrone acetate (a progestin). FDA-approved for treatment of moderate to severe vasomotor symptoms associated with menopause and for the prevention of postmenopausal osteoporosis in women with an intact uterus.

Bijuva is the first FDA-approved combination of bioidentical estradiol and progesterone in a single, oral softgel capsule. Approved for the treatment of moderate to severe vasomotor symptoms due to menopause in women with an intact uterus.

Evamist is a transdermal estradiol spray applied to the forearm. FDA-approved for the treatment of moderate to severe vasomotor symptoms associated with menopause, with precise metered-dose delivery.

Estradiol transdermal systems are FDA-approved hormone replacement therapy patches that deliver estrogen through the skin to treat moderate to severe vasomotor symptoms associated with menopause.

Estradiol vaginal cream is a local estrogen therapy that delivers estradiol directly to the vaginal tissues. FDA-approved for the treatment of vulvar and vaginal atrophy associated with menopause.

Estradiol vaginal ring is a flexible silicone ring containing estradiol that is inserted into the vagina and provides continuous release of estrogen locally. FDA-approved for the treatment of moderate to severe vaginal symptoms due to menopause.

Estradiol vaginal tablets are a local estrogen therapy that delivers a small, controlled dose of estradiol directly to vaginal tissues. FDA-approved for the treatment of atrophic vaginitis due to menopause, with minimal systemic absorption.

Fezolinetant is a neurokinin 3 (NK3) receptor antagonist that is FDA-approved for the treatment of moderate to severe vasomotor symptoms (hot flashes) associated with menopause. It represents a novel, non-hormonal treatment option.

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) FDA-approved for depression, anxiety disorders, and other psychiatric conditions, but frequently prescribed off-label for managing hot flashes and mood changes during menopause, especially when hormone therapy is contraindicated.

Gabapentin is an anticonvulsant medication that is FDA-approved for the treatment of seizures and postherpetic neuralgia. It is frequently prescribed off-label for the management of hot flashes in women who cannot or choose not to take hormone therapy.

Lasofoxifene is a selective estrogen receptor modulator (SERM) that has been investigated for the treatment of menopausal symptoms and postmenopausal osteoporosis. While approved in some countries, it is still investigational in the United States.

Mirtazapine is an atypical antidepressant FDA-approved for major depressive disorder but sometimes prescribed off-label for managing sleep disturbances and appetite/weight loss in menopausal women, due to its sedating effects and potential to stimulate appetite.

Ospemifene is an FDA-approved non-estrogen oral medication specifically for treating moderate to severe dyspareunia due to vulvar and vaginal atrophy, a symptom of menopause.

Oxybutynin is an anticholinergic medication available over-the-counter as a transdermal patch (Oxytrol for Women) for the treatment of overactive bladder, which commonly occurs during and after menopause due to estrogen decline. It helps manage urinary incontinence, urgency, and frequency.

Paroxetine mesylate is a selective serotonin reuptake inhibitor (SSRI) specifically FDA-approved for the treatment of moderate to severe vasomotor symptoms (hot flashes) associated with menopause. It is the first non-hormonal option approved for this indication.

Prasterone is a synthetic form of dehydroepiandrosterone (DHEA) that is FDA-approved for the treatment of moderate to severe dyspareunia (painful intercourse) due to vulvar and vaginal atrophy associated with menopause.

Pregabalin is an anticonvulsant and anxiolytic medication FDA-approved for neuropathic pain, fibromyalgia, and seizures, but sometimes prescribed off-label for managing hot flashes in menopausal women, particularly those with contraindications to hormone therapy.

Propranolol is a beta-blocker FDA-approved for treating hypertension, angina, and arrhythmias, but sometimes prescribed off-label to manage heart palpitations associated with menopause and anxiety components of hot flashes.

Annovera is a combination hormone contraceptive vaginal ring containing segesterone acetate and ethinyl estradiol. While primarily FDA-approved for contraception, it can help manage some menopausal symptoms in perimenopausal women or women in early menopause transition.

Spironolactone is a potassium-sparing diuretic and aldosterone antagonist FDA-approved for hypertension, heart failure, and edema, but often prescribed off-label for managing hormone-related acne and excess facial/body hair that can occur during the hormonal shifts of menopause.

Testosterone therapy for women is prescribed off-label to address hypoactive sexual desire disorder (HSDD) and low energy during menopause. While FDA-approved for men, testosterone is used in much lower doses for women to improve sexual function and overall wellbeing without causing masculinizing effects.

Testosterone is a hormone FDA-approved for men with hypogonadism but often prescribed off-label for postmenopausal women experiencing low sexual desire/libido. Used in low doses specifically for women to minimize masculinizing side effects.

Tibolone is a synthetic steroid with estrogenic, progestogenic, and androgenic properties used to treat menopausal symptoms and prevent osteoporosis. Widely available internationally but not FDA-approved in the United States.

Trazodone is an antidepressant FDA-approved for major depressive disorder but frequently prescribed off-label at lower doses as a sleep aid for women experiencing insomnia related to menopause, particularly when hormonal fluctuations or hot flashes disrupt sleep patterns.

Venlafaxine is a serotonin-norepinephrine reuptake inhibitor (SNRI) FDA-approved for depression and anxiety but commonly prescribed off-label at lower doses for managing hot flashes in menopausal women, especially those who cannot take hormone therapy.