Does sertraline (selective serotonin reuptake inhibitor) alleviate menopausal symptoms?

From the Guidelines

Sertraline can be an effective treatment for menopause symptoms, particularly hot flashes, with a reduction in hot flash composite score by 65% with daily sertraline, as seen in studies 1.

Key Points to Consider

• Sertraline, a selective serotonin reuptake inhibitor (SSRI), is prescribed at starting doses of 25-50mg daily, which may be increased to 100-200mg daily if needed, to help manage menopause symptoms such as hot flashes and mood-related issues like depression and anxiety.
• The medication works by increasing serotonin levels in the brain, which helps regulate body temperature and mood, thus alleviating hot flashes and other symptoms.
• While sertraline can be effective for these symptoms, it may not address other menopause symptoms like vaginal dryness or bone density loss.
• Common side effects include nausea, insomnia, sexual dysfunction, and dizziness, which often improve after the first few weeks.
• It's crucial to note that sertraline takes 2-4 weeks to reach full effectiveness, and patients should not stop taking it abruptly as this can cause withdrawal symptoms.
• Always consult with a healthcare provider before starting sertraline, especially if you have liver problems, bleeding disorders, or are taking other medications, as recommended by guidelines 1.

Additional Considerations

• Nonhormonal medications like SNRIs and SSRIs, including sertraline, can decrease the intensity and severity of vasomotor symptoms, although they are not approved by the US Food and Drug Administration for this indication.
• Lifestyle modifications and environmental changes, such as cool rooms, dressing in layers, avoiding spicy foods, caffeine, and alcohol, and exercise, can also help decrease the intensity and severity of menopausal symptoms.
• Complementary therapies, including acupuncture, have been studied and found to be minimally effective in reducing menopausal symptoms and hot flashes.

From the Research

Menopause Symptoms and Sertraline

• Sertraline is a selective serotonin reuptake inhibitor (SSRI) that has been studied for its effectiveness in reducing menopausal hot flashes 2.
• Research suggests that SSRIs, including sertraline, can reduce the frequency and severity of hot flashes in menopausal women 3, 4.
• A study published in 2007 found that sertraline had a variable response in women with menopausal hot flashes, with some women experiencing a significant reduction in hot flashes and others experiencing little to no improvement 2.
• Another study published in 2022 found that escitalopram, paroxetine, and fluoxetine were more effective than sertraline in reducing menopausal hot flashes, but noted that further research is needed to confirm the effectiveness of sertraline 4.

Efficacy and Safety of Sertraline

• Sertraline has been shown to be safe and well-tolerated in numerous patient populations, including those with psychiatric and/or medical comorbidities 5.
• Research has found that sertraline is effective in treating depressive and anxiety disorders, and its efficacy is unaffected by psychiatric comorbidity 5.
• Sertraline has a good tolerability profile and low fatal toxicity, making it a viable treatment option for menopausal women experiencing hot flashes 5.

Comparison to Other Treatments

• Hormone replacement therapy (HRT) has been shown to improve symptoms of anxiety and depression in menopausal women, but its effects on hot flashes are not directly comparable to those of sertraline 6.
• Other SSRIs, such as paroxetine and escitalopram, may be more effective than sertraline in reducing menopausal hot flashes, but sertraline may still be a viable treatment option for some women 4.