From the Guidelines
Non-hormonal treatments for menopause include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), gabapentin, and lifestyle modifications, which can effectively reduce hot flashes and improve quality of life. According to the most recent and highest quality study 1, these treatments can decrease the intensity and severity of vasomotor symptoms, with SSRIs and SNRIs reducing hot flashes by 50-60% within 2-4 weeks.
Treatment Options
- Selective serotonin reuptake inhibitors (SSRIs) like paroxetine (7.5-25mg daily) and escitalopram (10-20mg daily)
- Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as venlafaxine (37.5-150mg daily) and duloxetine (30-60mg daily)
- Gabapentin (300-900mg daily, typically at bedtime) for night sweats and sleep disturbances
- Clonidine (0.1-0.2mg daily) may help some women but has more side effects
Lifestyle Modifications
- Dressing in layers
- Using cooling fans
- Avoiding triggers like spicy foods, alcohol, and caffeine
- Maintaining a healthy weight
- Regular exercise
- Stress reduction techniques like yoga or meditation
- Cognitive behavioral therapy These non-hormonal approaches work by affecting neurotransmitters that regulate body temperature or by directly addressing symptom triggers, providing relief without the risks associated with hormone therapy 1. It is essential to note that while these treatments are effective, they may have side effects, and patients should be closely monitored and managed accordingly 1.
From the Research
Non-Hormonal Treatment Options
Non-hormonal treatments for menopause symptoms include:
- Lifestyle modifications
- Diet and food supplements
- Non-hormonal medications
- Behavioral and alternative medicine therapies 2
- Pharmacologic substances like antidepressants, anticonvulsants or antihypertensive drugs 3
- Complementary treatment, particularly over-the-counter phytotherapeutic extracts 4
Non-Hormonal Medications
Non-hormonal medications that can be used to manage menopausal symptoms include:
- Selective serotonin-reuptake inhibitors (SSRIs)
- Serotonin norepinephrine-reuptake inhibitors (SNRIs)
- Gabapentin 5, 2, 3
- Antidepressants
- Anticonvulsants
- Antihypertensive drugs 3
Alternative Therapies
Alternative therapies that may be beneficial for menopausal symptoms include:
- Yoga
- Exercise
- Hypnosis
- Acupuncture 3
- Phytopharmaceutical products, such as isoflavons and extracts of cimicifuga racemosa 3, 4
- Nutraceutical compounds, such as soy extract and red clover or extracts from evening primrose 4, 6
Efficacy and Safety
The efficacy and safety of non-hormonal treatments for menopausal symptoms vary:
- Non-hormonal medications, such as SSRIs and gabapentin, have been shown to be effective in reducing hot flashes and other menopausal symptoms 5, 2
- Alternative therapies, such as yoga and acupuncture, may have beneficial effects, but more research is needed to confirm their efficacy 3
- Nutraceutical compounds, such as soy extract and red clover, may have beneficial effects, but their safety and efficacy are not well established 4, 6