

JAMA Internal Medicine : Nonhormonal Treatment of Menopausal Vasomotor Symptoms
11 snips Aug 25, 2025
In this enlightening discussion, Alison J. Huang, a prominent professor at UCSF, and Stephanie Faubion, a leading expert at the Mayo Clinic, tackle the complexities of managing menopausal vasomotor symptoms like hot flashes and night sweats. They delve into FDA-approved non-hormonal medications and evaluate their effectiveness compared to traditional options. The conversation highlights the significant challenges women face, including insurance hurdles and the need for better healthcare provider training. Misinformation and the importance of evidence-based treatments are also key topics, emphasizing the need for informed patient-provider conversations.
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FDA-Approved Nonhormonal Options
- Two FDA-approved nonhormonal drugs exist: low-dose paroxetine and a neurokinin-3 receptor antagonist.
- These offer evidence-backed options when hormone therapy is contraindicated or unwanted.
Reserve SSRIs For Dual Indications
- Avoid antidepressants primarily for hot flashes unless mood symptoms are present because their benefit over placebo is small.
- Prefer them only when you expect dual benefit for depression or anxiety alongside vasomotor symptom relief.
Fezolinetant May Be Effective But Hard To Access
- Consider fezolinetant when accessible, but expect insurance and access barriers currently.
- Reassess this option over time as cost and availability improve with competition.