Symptom-to-treatment matrix
Cross-reference 10 symptoms × 9 treatment options. Effectiveness tiers based on clinical literature. Use as a starting point — discuss specific options with your clinician.
Effectiveness legend
First-lineEffectiveModestLimitedNot indicated
| Symptom | HRT | Vaginal estrogen | GLP-1 | SSRI | Fezolinetant | Spironolactone | CBT | Lifestyle | Acupuncture |
|---|---|---|---|---|---|---|---|---|---|
| Hot flashes HRT reduces 70-80%. SSRIs/fezolinetant 50-70%. CBT addresses bother, not frequency. | First-line | Not indicated | Not indicated | Effective | Effective | Not indicated | Modest | Limited | Modest |
| Night sweats / sleep disruption | First-line | Not indicated | Not indicated | Effective | Effective | Not indicated | Effective | Modest | Modest |
| Vaginal dryness Vaginal estrogen most targeted. Systemic HRT also helps. DHEA suppository alternative. | Effective | First-line | Not indicated | Not indicated | Not indicated | Not indicated | Not indicated | Limited | Not indicated |
| Mood swings / irritability CBT + SSRI for depressive episodes. HRT helps hormone-driven mood changes. | Effective | Not indicated | Not indicated | First-line | Limited | Limited | First-line | Modest | Modest |
| Brain fog HRT data limited but observational benefit. Sleep + exercise high-leverage. | Effective | Not indicated | Limited | Limited | Limited | Not indicated | Modest | Effective | Not indicated |
| Joint pain Exercise + weight management high impact. HRT helps estrogen-driven inflammation. | Effective | Not indicated | Modest | Limited | Not indicated | Not indicated | Modest | First-line | Effective |
| Weight gain | Limited | Not indicated | First-line | Not indicated | Not indicated | Limited | Modest | Effective | Limited |
| Hirsutism (PCOS) Spironolactone blocks androgens. Combined OCP useful alternative. | Limited | Not indicated | Limited | Not indicated | Not indicated | First-line | Not indicated | Modest | Limited |
| Low libido Testosterone (off-label) effective for HSDD. Vaginal estrogen helps dyspareunia-driven low libido. | Effective | Effective | Not indicated | Limited | Not indicated | Limited | Modest | Modest | Modest |
| Bone loss / osteoporosis HRT primary prevention. Bisphosphonates (Fosamax) for established osteoporosis. Resistance training + Ca/D foundational. | First-line | Not indicated | Not indicated | Not indicated | Not indicated | Not indicated | Not indicated | Effective | Not indicated |
How to use this
- Identify your top 2-3 symptoms.
- Look across the row for "first-line" or "effective" cells.
- Cross-reference contraindications + cost on individual treatment pages.
- Discuss with a clinician.
Try also: decision tree · brand matcher