Menopause care at Rosedale, West Pennant Hills
Menopause treatment options in Australia: MHT and non-hormonal care
There is no single best menopause treatment. The useful question is which symptoms are affecting you, what else is happening in your health, and which option has the right balance of benefit, risk and practicality for you.
The short answer
Australian options include menopausal hormone therapy (MHT, also called HRT), local vaginal oestrogen, non-hormonal prescription medicines, contraception where it is still needed, and practical support for sleep, movement, nutrition and mental health. Treatment should match the symptom and the person, not a trend, a single blood result or a fixed script.
Dr Jaspreet Saini, MBBS, FRACGP
Principal GP and owner, Rosedale Medical Practice. Evidence reviewed 27 September 2026.
What are the main menopause treatment options?
The Australian Government lists several evidence-based approaches: menopausal hormone therapy, hormonal contraception in some perimenopausal women, non-hormonal prescription medicines, local treatments, physical therapies and lifestyle or behavioural strategies. Its national menopause resource explains the available categories.
1. Menopausal hormone therapy (MHT or HRT)
MHT replaces some of the oestrogen, and where needed progestogen, that declines around menopause. It is the most effective treatment for hot flushes and night sweats and can also help some women with sleep disruption, vaginal symptoms and bone protection. Healthdirect summarises how MHT works and its benefits and risks.
The form matters. Oestrogen may be given through a patch, gel, spray or tablet. If you have a uterus, endometrial protection with a progestogen is generally required. The right combination depends on bleeding, contraception, migraine, clot risk, medical history and preference.
Good to know
For many healthy women around the expected age of menopause, benefits are likely to outweigh risks, but this must be assessed individually. The Australian Government menopause myths and facts page explains why MHT is neither universally unsafe nor automatically suitable for everyone.
2. Local vaginal oestrogen and genitourinary care
Low-dose vaginal oestrogen acts locally and may help dryness, irritation, pain with sex, urinary urgency and recurrent urinary tract infections. It is different from systemic MHT. Moisturisers, lubricants, pelvic floor physiotherapy and assessment for infection or skin conditions may also be useful. Our guide to genitourinary syndrome of menopause is coming later in October.
3. Non-hormonal prescription options
Non-hormonal medicines can reduce hot flushes or address sleep and mood symptoms when MHT is not wanted or is not suitable. The choice depends on the main symptom, other conditions, current medicines and possible side effects. These medicines still need an individual discussion: non-hormonal does not mean risk-free.
4. Contraception during perimenopause
MHT is not contraception. Some women in perimenopause need symptom treatment and reliable pregnancy prevention at the same time. Depending on age and medical history, options can include hormonal contraception or an intrauterine device alongside oestrogen. This is one reason treatment needs to consider the whole timeline rather than menopause symptoms alone.
5. Sleep, movement, nutrition and psychological support
Lifestyle measures can improve health and make symptoms easier to manage, but persistent symptoms are not a failure of willpower. Useful priorities often include:
- resistance and weight-bearing exercise
- enough protein and calcium
- less alcohol if it triggers flushes
- treating sleep apnoea or insomnia (see our guide to night sweats and the 3am wake-up)
- addressing anxiety or low mood (see perimenopause anxiety and mood changes)
The Australian Government outlines practical symptom-management strategies.
6. Prevention and long-term health
A menopause consultation is also a chance to review blood pressure, cholesterol and diabetes risk, bone health, cervical and breast screening, contraception, sexual health and mental health. Not every woman needs every test. The aim is to close genuine gaps, not create a shopping list.
How a GP decides what may suit you
Your symptoms
Clarify the stage of the transition and which symptoms are causing the most disruption.
Other causes
Check for conditions that can coexist, such as thyroid disease, iron deficiency, sleep apnoea and mental health conditions.
Your history
Review bleeding, migraine, heart and clot risk, cancer history, current medicines and contraception.
A shared plan
Talk through benefits, side effects and costs, then agree a review point and what improvement should look like.
When to seek review promptly
Before you wait it out
- Bleeding after 12 months without a period.
- Very heavy bleeding, bleeding between periods or bleeding after sex.
- New chest pain, shortness of breath, one-sided weakness or a painful swollen leg: call 000.
- Severe low mood, thoughts of self-harm or feeling unsafe: call Lifeline on 13 11 14, or 000 in an emergency.
Common questions
Is MHT the same as HRT?
Yes. Menopausal hormone therapy is the newer term for hormone replacement therapy in the menopause context.
Do I have to wait until my periods stop?
No. Treatment can be considered during perimenopause when symptoms are affecting quality of life. The regimen may differ depending on whether periods continue and whether contraception is needed.
How quickly should treatment work?
It depends on the symptom and the treatment. Some women notice change within weeks; other outcomes take longer. A planned review matters so benefits and side effects can be assessed rather than leaving treatment on autopilot.
Are compounded bioidentical hormones safer?
Treat these claims cautiously. Regulated body-identical MHT products are available in Australia. Compounded products may have less reliable dosing and safety evidence, so discuss any product with a doctor before using it.
Build a plan around your priorities
You do not need to choose between natural and medical care as competing teams. Good menopause care uses the safest evidence-based options that match your goals, then checks how the plan is working. Our menopause GPs offer an unhurried 40-minute consult, in person with Dr Natasha Paul in West Pennant Hills or by video Australia-wide with Dr Priya Ashwath. No referral is needed. The initial consult is $330, about $202 out of pocket after the $128.35 Medicare rebate.
Not ready to book? Start with our free perimenopause self-check, or see our menopause care page.
Rosedale Medical Practice, Ground Floor, 70 Castle Hill Road, West Pennant Hills. GP-owned and family-run, caring for Hills District families since 1997. Care Outside the Box®. This article is general information and does not replace individual medical advice.