Non-Hormonal Management of Menopausal Symptoms: What is the latest evidence?

Vasomotor symptoms (hot flushes and night sweats) affect up to 80% of menopausal  women and can significantly impact quality of life, lasting an average of 7-9 years, with  some women experiencing symptoms for more than a decade. While hormone therapy  remains the most effective treatment for these symptoms, not all women are candidates  due to medical contraindications or personal preference.

Mind-Body Therapies That Work

Two highly effective non-drug treatments have strong scientific backing: Cognitive  Behavioral Therapy (CBT) and Clinical Hypnosis. CBT helps up to 78% of women achieve  meaningful improvements by teaching practical coping strategies and changing how you  think about hot flushes. Clinical Hypnosis uses guided relaxation and calming imagery to  reduce hot flush frequency and severity. Both can be delivered through in-person sessions,  online programs, or smartphone apps, making them accessible and convenient.  

Prescription Medications

Several medications effectively reduce hot flushes. Antidepressants decrease symptoms in a majority of women within two weeks and work even if you're not depressed. Gabapentin, originally used for nerve pain, is remarkably effective and its drowsiness side effect makes it ideal if hot flushes disrupt your sleep. Fezolinetant, FDA-approved in 2023, is a breakthrough medication that blocks the brain mechanism triggering hot flushes, reducing frequency by nearly 60% within two weeks. Oxybutynin, traditionally used for overactive bladder, significantly reduces moderate to severe hot flushes but may cause dry mouth and constipation. Your healthcare provider can help determine which option best suits your symptoms and medical history.

Lifestyle and Other Approaches

Weight loss through behavioral programs may help reduce hot flushes, particularly for women with extra weight in the earlier stages of menopause.

Talk to Your Healthcare Provider

At Menopause Wellness Hub, we specialize in providing comprehensive, evidence-based care using both hormonal and non-hormonal approaches tailored to your individual needs. Our multidisciplinary team of GPs and allied health professionals work together to create a coordinated, personalized management plan for your menopause journey.

References

1. The North American Menopause Society. (2023). The 2023 nonhormone therapy  position statement of The North American Menopause Society. Menopause, 30(6),  573-590. 

2. Simon, J. A., et al. (2025). State of the art in menopause: current best practice  approaches from the IMS World Congress 2024, Melbourne. Climacteric, 28(2), 98- 103. 

3. Huang, A. J., Faubion, S., & Grady, D. (2025). Nonhormonal treatment of  menopausal vasomotor symptoms. JAMA Internal Medicine. 

4. Iyer, T. K., Fiffick, A. N., & Batur, P. (2024). Nonhormone therapies for vasomotor  symptom management. Cleveland Clinic Journal of Medicine, 91(4), 237-244. 5. Contemporary OB/GYN(2025). Nonhormonal therapies transform menopause care  in 2025.

This blog post is for educational purposes only and should not replace medical advice from your healthcare provider. Always consult with a qualified healthcare professional before starting any new treatment.