Non-hormonal management of menopausal vasomotor symptoms

Hot flashes are a common menopausal symptom. They tend to intensify during the perimenopause and usually subside within 5 years after the final menstrual period. However in some women frequent hot flashes are a long term problem and may last for more than 7 years. While estrogen-based menopausal hormone therapy is the most effective treatment it is not indicated for all women, such as those with a personal history of breast cancer. The position statement provides a practical guide to non-hormonal management.

It covers lifestyle modifications, diet and food supplements, non-hormonal medications and use of behavioral and alternative medicine therapies. The key conclusions are that there is insufficient or conflicting evidence to suggest that exercise, supplements or a diet rich in phytoestrogens are effective for hot flashes. Selective serotonin-reuptake inhibitors (SSRIs), serotonin norepinephrine-reuptake inhibitors (SNRIs) and gabapentin could be proposed as alternatives to estrogen-based therapies. Behavioral therapies and alternative medicine interventions have been tried, but the available evidence is still limited.

Thus women who cannot take estrogens should be able to discuss non-hormonal options with their health professional.

These and other recommendations presented in EMAS' position statement are published in the article: "EMAS position statement: Non-hormonal management of menopausal vasomotor symptoms" in Maturitas published by Elsevier: