Women typically experience menopause-related symptoms when they’re in their 30s and 40s as their body begins to produce less estrogen. These symptoms may include hot flashes, vaginal dryness, trouble sleeping, bladder issues, a lower sex drive, and mood changes. The transition to menopause can also increase the risk for heart disease or bone density issues, like osteoporosis.
Advances in medicine and treatment can help alleviate these symptoms for women with declining estrogen levels. From hormone replacement therapies to topical treatments, there are options to explore for relief.
Perimenopause vs. Menopause: Which Treatment Do You Need?
The entire menopausal transition lasts about 7 years for most people, but it can last for up to 14 years. There are multiple menopause-related treatments available, ranging from low-dose birth control to menopausal hormone therapy (MHT). The best one for you depends on your symptoms and where you are in the menopausal transition:
- Perimenopause: This stage begins when your hormones first start to shift and continues until menopause. Perimenopause usually begins in your 40s. Hot flashes, trouble sleeping, and irregular periods are all common during this stage. During this stage, treatments often aim to regulate fluctuating hormone levels.
- Menopause: This stage is the moment when 12 consecutive months have passed since your last menstrual period. Menopause most commonly happens in your 50s. It can also be induced through the removal of both ovaries.
- Postmenopause: The final stage of the menopausal transition describes the rest of your life after menopause. In casual conversation, when people say someone is “in menopause,” they generally mean postmenopause. During this stage, treatments often aim to provide a continuous level of hormones or prevent bone loss.
Other menopause-related treatments may be used throughout different stages to address specific symptoms, like hot flashes, vaginal dryness, or depression.
Common Menopause Treatment Options
Learn more about common hormonal and nonhormonal medical treatments used to ease symptoms throughout the menopausal transition.
| Treatment | Systemic or Localized? | Menopause Phase |
| Estrogen-only patches, pills, creams, sprays, or gels | Systemic | Perimenopause, postmenopause (including those who have had their uterus removed) |
| Combination estrogen and progesterone patches or pills | Systemic | Perimenopause, postmenopause |
| Low-dose hormonal birth control | Systemic | Perimenopause |
| Vaginal estrogen creams | Localized | Perimenopause, postmenopause |
| Vaginal inserts and rings | Localized, systemic | Perimenopause, postmenopause |
| Supplements | Systemic | Perimenopause, postmenopause |
| Non-hormonal treatments (low-dose antidepressants, neurokinin 3 (N3) receptor antagonists, nerve pain medications) | Systemic | Perimenopause, postmenopause |
Estrogen-Only Patches, Pills, Creams, Sprays, or Gels
Estrogen therapy (ET) is a form of hormone replacement therapy (HRT), also called menopausal hormone therapy (MHT). Estrogen therapy may reduce symptoms like hot flashes and vaginal dryness. This treatment can be taken orally or applied topically as creams, sprays, or gels. The estrogen patch for menopause is a common topical treatment, available in once-weekly and twice-weekly menopause patch formulations.
Estrogen-only therapy is generally recommended for people who have had a hysterectomy (the removal of the uterus). Because taking estrogen alone can pose a risk to the lining of the uterus, a combination hormonal therapy is recommended to those who have a uterus.
Combination Estrogen and Progesterone Patches or Pills
Patches and pills that contain both estrogen and progesterone hormones are a type of hormone therapy called combination treatments. Even though combination therapy treatments contain similar ingredients to common birth control medications, menopause treatments are not intended to prevent pregnancy.
Combination therapy can be taken orally or applied topically, such as with a hormone patch for menopause. In addition to providing relief for hot flashes and vaginal dryness, these treatments may also reduce the risk of osteoporosis. In perimenopause, treatment dosages may reflect normal hormone levels throughout a monthly cycle. After menopause, treatments may shift to a dosage that remains the same.
Low-Dose Hormonal Birth Control
Because people in perimenopause may still be able to get pregnant, low-dose hormonal birth control is another treatment option for menopause-related symptoms. Like combination hormone replacement therapy, hormonal birth control often contains both estrogen and progesterone. This treatment can potentially reduce symptoms of perimenopause, while also preventing pregnancy and regulating menstrual periods.
Vaginal Estrogen Creams
Vaginal estrogen creams are inserted into the vagina to reduce dryness and related discomfort. These creams may also strengthen vaginal walls, which can become thinner in perimenopause or postmenopause. Vaginal estrogen creams are a localized treatment option, which means the medication generally stays within one area of the body (the vagina) instead of being a systemic treatment that affects the entire body, like oral medications.
Vaginal Inserts and Rings
Vaginal inserts and rings are another form of estrogen therapy used to treat menopause symptoms. Many of these products primarily treat local symptoms such as vaginal dryness, irritation, and painful intercourse by delivering low doses of estrogen directly to vaginal tissues with limited systemic absorption.
Some vaginal rings, such as Femring, deliver enough estrogen into the bloodstream to produce systemic effects. These products may help treat both vaginal symptoms and broader menopause symptoms such as hot flashes and night sweats.
The Best Online Menopause Treatment for 2026
If you are grappling with symptoms related to menopause, finding the best online menopause treatment is now an easy option. Telehealth platforms, including TelyRx, offer a range of prescription menopause medications that can be prescribed online and shipped directly to your home.
In 2025 and 2026, access to menopause treatments increased as the U.S. Food and Drug Administration (FDA) began removing warning labels from certain hormone replacement therapy and menopause hormone therapy medications. These updates reflect newer evidence suggesting that risks vary based on the type of hormone therapy, dose, route of administration, and timing of use. This helps ensure that treatment decisions are based on up-to-date evidence rather than older one-size-fits-all warnings.
TelyRx carries systemic and localized estrogen-only and combination hormone treatments available as pills, patches, gels, creams, and inserts to treat menopause-related discomfort. In addition, non-hormonal options commonly used to address menopause-related symptoms are also available for those who prefer an alternative to hormone therapy.
Non-Hormonal and Natural Menopause Alternatives
If menopause hormone therapy is not an ideal treatment for you, non-hormonal menopause treatment options are also available. In 2023, the FDA approved a neurokinin 3 (N3) receptor antagonist to treat moderate-to-severe hot flashes linked to menopause. Other non-hormonal medications can be prescribed off-label to treat menopause-related symptoms, such as antidepressants and certain nerve pain medications.
Supplements for Menopause Comfort
In addition to prescription medications, menopause supplements are sought out to help with symptoms. Keep in mind that unlike medications, supplements are not FDA-approved to treat any illnesses or cure any symptoms. However, some supplements have been widely researched and may complement other treatment options:
- Magnesium Glycinate: Magnesium is an essential mineral in the body. Research shows fluctuating hormone levels during the menopausal transition may reduce magnesium levels. For this reason, supplementing with magnesium may be beneficial. Magnesium supplements may promote calmness and sound sleep during a time when perimenopausal and postmenopausal adults are facing mood swings that cause “meno-rage” and frequent sleep disturbances.
- Creatine: Essential amino acids combine to form creatine, a supplement that acts as a source of energy. Research shows that creatine may help people in the menopausal transition gain lower body strength and improve sleep quality.
- Omega-3s: Omega-3s are healthy oils naturally found in some fish, nuts, seeds, and vegetables. Research has suggested that omega-3s may help with brain fog, mood swings, and more during the menopausal transition.
Before beginning any supplements for menopause, ensure that the supplement ingredients will not interact with any of your current medications or conditions.
Your Next Steps
The menopausal transition can bring on a variety of troublesome symptoms that last for years, but relief is available. Whether you prefer oral medications, topical creams or patches, or targeted vaginal inserts, menopausal hormone treatment is now more accessible than ever. There is also growing support for non-hormonal medications and supplements that may be used alongside hormonal treatments or on their own for those who cannot take hormones.
You do not have to cope with menopause discomfort. Find the treatment(s) you need to feel comfortable as you move throughout the stages of menopause.
Our experts
Written by
Amy Tran, Director of Content
Amy Tran is the Director of Content at TelyRx, where she leads content strategy focused on making complex health and medication topics easier to understand. She holds a Bachelor of Science in Journalism from Boston University and brings more than a decade of experience in web content writing, production, and editorial leadership.
Reviewed by
Ashley Robinson, PharmD
Ashley Robinson oversees daily operations at TelyRx's Clearwater pharmacy location, optimizes workflow efficiency, and ensures compliance with regulatory standards while maintaining a strong focus on patient safety and quality of care. She collaborates closely with clinical and operations teams to evaluate new medications, support formulary development, and implement process improvements that enhance both patient outcomes and team performance.
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