Section 1: Prescription Treatments for VMS

Pharmacological Treatments are controlled medications. Thesetreatments may be hormonal or non-hormonal medications and usually require a prescription from your healthcare provider.

Menopause Hormone Therapy (MHT),also referred to as Hormone Replacement Therapy (HRT) or Hormone Therapy (HT), is a medication that contains female hormones — estrogen or progesterone. It aims to replenish the estrogen your body stops producing during perimenopause and after menopause. Hormone therapy is prescribed by doctors and is used to treat common symptoms related to menopause transition, including hot flashes, mood imbalance, and discomfort due to vaginal dryness or thinning. Hormone therapy may also be prescribed to post-menopausal women at risk of osteoporosis (i.e., bone loss and fracture-prone) or to struggling with insomnia or other sleep disturbances. 

For many women experiencing VMS, hormone therapy can be a safe and effective option. However, it may pose greater health risks for some. For example, women with estrogen-dependent cancers or a history of or risk for blood clot formation are not candidates for hormone therapy​. 

In addition to family and medical history, health risks should also be considered according to the dosage, duration, and type of hormone therapy you’re taking. Because of this, hormone therapy should be tailored to the individual and regularly re-evaluated by your doctor to ensure the benefits continue to outweigh the risks. 

Non-hormonal medications are alternatives for women who can’t or choose not to take HRT. These include:

• Fezolinetant (brand name Veozah®): Veozah® was approved by the FDA in 2023. It helps to reduce the number and severity of menopausal hot flashes and night sweats by blocking a chemical in your brain called neurokinin B (NKB). Veozah® is a non-hormonal treatment that works by restoring the balance between estrogens and NKB, which can trigger vasomotor symptoms.

• Antidepressants: Certain types, like SSRIs and SNRIs, can help reduce hot flashes. Possible side effects include nausea, dizziness, weight gain, and sexual dysfunction. These medications may take a few weeks to start working and should not be stopped abruptly.

• Gabapentin: Originally used for seizures, this can also alleviate hot flashes. Side effects include drowsiness, dizziness, and unsteadiness. Start with a low dose and gradually increase as directed by your healthcare provider.

• Clonidine is a medication for high blood pressure that can also reduce hot flashes. Side effects include dry mouth, drowsiness, and constipation. You need to monitor your blood pressure regularly and avoid alcohol, as it can enhance drowsiness.