CHICAGO -- A multidisciplinary group of menopause experts developed new comorbidity-specific guidance on non-hormone therapy for moderate-to-severe vasomotor symptoms.
For patients whose primary menopausal symptoms are hot flashes and night sweats, first-line neurokinin (NK)-receptor antagonists are recommended, with alternative or second-line treatment options including selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), gabapentin, and oxybutynin, noted JoAnn Pinkerton, MD, of the University of Virginia Health System in Charlottesville, at ENDO 2026, the annual meeting of the Endocrine Society.
NK-receptor antagonists, like fezolinetant (Veozah) and elinzanetant (Lynkuet), have strong evidence for managing hot flashes, Pinkerton said, and while access is limited, it is improving.
The group opted not to recommend clonidine due to rebound hypertension, as well as most herbal and over-the-counter products, since better options are available.
Pinkerton stressed that hot flashes are common and disruptive to menopausal women, and hormone therapy is contraindicated for or declined by many patients.
