Hot flushes, night sweats, sleepless nights and mood changes can make menopause difficult for many women, but new clinical guidelines outline a wider range of treatments that could help them manage these symptoms and improve their quality of life.

The guidelines, published in the journal Obstetrics & Gynaecology, outline treatment options for menopause symptoms, including hormone therapy, nonhormonal medicines and approaches such as exercise and psychological support. They update recommendations issued in 2014.

Menopause is a natural stage in a woman's life when menstrual periods stop permanently, usually between the ages of 45 and 55. The transition leading to menopause can bring changes in hormone levels that affect body temperature, sleep, mood and overall well-being.

According to the guidelines, between 50 and 92 per cent of women going through menopause experience hot flushes and night sweats. These symptoms occur when changes in the body's temperature regulation cause sudden feelings of heat, sweating and sometimes chills.

Sleep problems are also common, with 16 to 66 per cent of women reporting menopause-related sleep disruption. More than one-third of women worldwide who are approaching or have reached menopause also report depressive symptoms.

The guidance aims to help healthcare providers choose treatments based on a woman's symptoms, medical history and personal preferences rather than relying on a one-size-fits-all approach.

“Hormone therapy can be a great option and, in many cases, the best option but may not be appropriate or helpful for every person experiencing menopausal symptoms,” the researchers said.

Hormone therapy replaces hormones, mainly oestrogen, that decline during menopause. The guidelines recommend systemic menopausal hormone therapy for women experiencing hot flushes and related sleep problems if they have no medical reasons that would make the treatment unsafe.

Women who still have a uterus generally need oestrogen combined with a progestogen to protect the lining of the womb. Those who do not need this protection may use oestrogen alone, depending on their medical circumstances.

However, treatment should be discussed with a healthcare provider. Factors such as age, time since menopause began, medical history and the risk of conditions including blood clots, stroke and breast cancer should inform the decision.

The guidelines recommend considering hormone therapy before the age of 60 or within 10 years of the onset of natural menopause for women who are suitable candidates. This does not mean the treatment is safe for everyone in this age group; individual risks must still be assessed.

For women who cannot take hormone therapy or prefer not to use it, the guidelines recommend several nonhormonal medicines. These include certain antidepressants, known as selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors, which can help reduce hot flushes and may also help manage depression.

The guidance also recommends neurokinin receptor antagonists, a newer group of medicines that act on brain pathways involved in regulating body temperature. These medicines may help reduce hot flushes and related symptoms.

Menopause is an important public health issue affecting millions of women worldwide, yet many receive limited information and support. The World Health Organisation (WHO) estimates that more than one billion women will be living through menopause or postmenopause by 2030.

Menopause usually occurs between the ages of 45 and 55, although the timing varies. Symptoms include hot flushes, night sweats, sleep disturbances, mood changes, joint pain, vaginal dryness and difficulty concentrating. Some women experience symptoms for several years, affecting their health, relationships and quality of life.

Globally, research published in BMC Public Health in 2024, based on a review of 321 studies involving more than 482,000 women, found that joint and muscle discomfort affected an estimated 65.4 per cent of women.

Hot flushes were reported by 65.9 per cent of women in lower-income countries and 49.7 per cent in high-income countries. Vaginal dryness affected an estimated 44.8 per cent of postmenopausal women. These figures vary across populations and are not specific to Kenya.

In Kenya, nationally representative data on menopause and its symptoms remain limited. However, local studies highlight the challenges women face. A study in rural western Kenya found a median age at menopause of 48.3 years, while a study of 478 health workers in Kiambu County linked menopausal symptoms to absenteeism and reduced workplace productivity.

Women may struggle with hot flushes, insomnia, anxiety, low mood and reduced concentration, yet lack adequate information or access to treatment. Stigma and embarrassment can also prevent open discussion of symptoms, particularly those affecting sexual health.

Limited workplace support and inadequate health-worker training may further complicate their experiences. Experts say better public awareness, accessible healthcare and more research are needed to ensure women receive appropriate support during this stage of life.