Management of Menopause Symptoms

March 2025 in “ Primary Care Clinics in Office Practice ”

Julia Snyder, Coral Matus, E. M. Landis, Robin A. Barry, Linda Speer

menopausal hormone therapy vasomotor symptoms SSRIs SNRIs fezolinetant cognitive behavioral therapy genitourinary syndrome of menopause topical estrogen female pattern hair loss topical minoxidil oral finasteride MHT VSM CBT Rogaine Propecia

TLDR Menopausal hormone therapy is best for hot flashes, while other options include SSRIs, SNRIs, fezolinetant, and lifestyle changes.

The document discusses various treatments for menopause symptoms, highlighting that menopausal hormone therapy (MHT) is the most effective for vasomotor symptoms (VSM) like hot flashes and night sweats, especially for women under 60 or within 10 years of menopause onset. Nonhormonal options include SSRIs, SNRIs, and the new drug fezolinetant. Nonpharmacological treatments such as cognitive behavioral therapy, weight loss, and smoking cessation are also recommended. For genitourinary syndrome of menopause, topical estrogen is the first-line treatment. Female pattern hair loss affects about 50% of menopausal women, with topical minoxidil and oral finasteride as potential treatments.

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The Relative Effect of Monotherapy with 5-Alpha Reductase Inhibitors and Minoxidil for Female Pattern Hair Loss: A Network Meta-Analysis Study

research The Relative Effect of Monotherapy with 5-Alpha Reductase Inhibitors and Minoxidil for Female Pattern Hair Loss: A Network Meta-Analysis Study

June 2023 in “Journal of Cosmetic Dermatology”

Finasteride 5mg daily is the most effective for female pattern hair loss, with higher doses of treatments generally more effective.

research A Systematic Review of Clinical Trials Using Single or Combination Therapy of Oral or Topical Finasteride for Women in Reproductive Age and Postmenopausal Women with Hormonal and Nonhormonal Androgenetic Alopecia

March 2023 in “Advances in Clinical and Experimental Medicine”

Oral and topical finasteride are effective and safe for treating female hair loss.

research Female Pattern Hair Loss and Androgen Excess: A Report From the Multidisciplinary Androgen Excess and PCOS Committee

49 citations , February 2019 in “The Journal of Clinical Endocrinology and Metabolism”

Use "female pattern hair loss" term, assess androgen excess, treat with minoxidil and other medications if needed.

research The Efficacy and Use of Finasteride in Women: A Systematic Review

23 citations , January 2019 in “International Journal of Dermatology”

Finasteride improves hair growth and reduces hirsutism in women, but side effects and optimal dosages need further research.

research Interventions for Female Pattern Hair Loss

15 citations , January 2017 in “JAMA Dermatology”

Topical minoxidil improves female pattern hair loss, finasteride not effective, laser devices show mixed results.

research Interventions for Female Pattern Hair Loss

21 citations , May 2016 in “The Cochrane library”

Topical minoxidil helps treat female pattern hair loss, but more research needed for other treatments.