Longevity & AgingMenopause Experts Issue First Comorbidity-Specific Guide to Non-Hormone Hot Flash Treatment
A multidisciplinary panel of 15 menopause specialists has released the first U.S. guidance specifically tailored to treating moderate-to-severe hot flashes and night sweats in women who cannot or choose not to use hormone therapy. The recommendations account for 13 comorbidities — including cardiovascular disease, cancer history, and autoimmune conditions — giving doctors and patients a clearer roadmap. Neurokinin-receptor antagonists like fezolinetant and elinzanetant are the recommended first-line options, with SSRIs, SNRIs, gabapentin, and oxybutynin as alternatives. Clonidine and most herbal remedies were excluded. The guidance was developed using a modified Delphi process and a systematic review of U.S. guidelines from 2014 to 2024, and was presented at the Endocrine Society's ENDO 2026 annual meeting.
