Treatment
12
Nonhormonal Therapies for VMS
Î For postmenopausal women with mild or less bothersome
hot flashes, ES suggests a series of steps that do not involve
medication, such as turning down the thermostat, dressing in
layers, avoiding alcohol and spicy foods, and reducing obesity and
stress. (2|⊕⊕
)
Nonhormonal Prescription Therapies for VMS
Î For women seeking pharmacological management for moderate
to severe VMS for whom MHT is contraindicated, or who
choose not to take MHT, ES recommends selective serotonin
reuptake inhibitors (SSRIs)/serotonin norepinephrine reuptake
inhibitors (SNRIs) or gabapentin or pregabalin (if there are no
contraindications). (1|⊕⊕⊕
)
Î For those women seeking relief of moderate to severe VMS who
are not responding to or tolerating the nonhormonal prescription
therapies, SSRIs/SNRIs or gabapentin or pregabalin, ES suggests
a trial of clonidine (if there are no contraindications). (2|⊕⊕
)
Over-the-Counter and Alternative Nonhormonal Therapies for VMS
Î For women seeking relief of VMS with over-the-counter (OTC)
or complementary medicine therapies, ES suggests counseling
regarding the lack of consistent evidence for benefit from
botanicals, black cohosh, omega-3-fatty acids, red clover,
vitamin E, and mind/body alternatives including anxiety control,
acupuncture, paced breathing, and hypnosis. (2|⊕⊕
)
