Hormone therapy isn't the only effective option. Several non-hormonal medications and approaches can meaningfully reduce hot flashes and night sweats.
Yes, non-hormonal options exist. FDA-approved non-hormonal medications for hot flashes include a low dose of an antidepressant called paroxetine and a newer medication called fezolinetant, alongside approaches like cognitive behavioral therapy. A clinician can help match an option to your symptoms and health history.
Hormone therapy is generally considered the most effective treatment for hot flashes, but it isn't the only option, and it isn't appropriate or preferred for every woman. Whether due to a personal health history, a preference to avoid hormones, or simply wanting to try something else first, several non-hormonal approaches have real evidence behind them.
On the medication side, a low dose of paroxetine, an SSRI antidepressant, has been used for years to reduce hot flashes. More recently, fezolinetant, in a newer class of medication called neurokinin B antagonists, was developed specifically to target the pathway in the brain involved in hot flashes, rather than being borrowed from another use. Both are government-approved options a clinician can discuss with you.
Beyond medication, cognitive behavioral therapy and clinical hypnosis both have evidence supporting their use, and simple lifestyle steps, layering clothing, identifying personal triggers like caffeine, alcohol, or spicy food, and using cooling strategies, can help some women, especially with milder symptoms. Evidence for supplements and over-the-counter products is generally more limited and varies by product, so it's worth discussing any supplement with a clinician before starting it, particularly alongside other medications.
Source: The Menopause Society
These are the main non-hormonal options with evidence behind them. A clinician can help match one, or a combination, to you.
Not every patient wants or can use hormone therapy, and that's a legitimate starting point, not a limitation.
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