NAMS Releases Statement on Non-Hormone Therapy for Hot Flashes, Night Sweats
The North American Menopause Society (NAMS) has issued its latest position statement on non-hormonal treatments for hot flashes and night sweats.
The position statement was published online on June 1, 2023, by The Journal of The North American Menopause Society. Read “The 2023 nonhormone therapy position statement of The North American Menopause Society.”
The North American Menopause Society is a multidisciplinary organization that includes clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, epidemiology, and pharmacy, among other specialties. The group promotes the health and quality of life of all women during midlife and beyond through an understanding of menopause and healthy aging.
About hot flashes
Hot flashes and night sweats — called vasomotor symptoms by doctors — are the most common menopausal symptoms. Up to 80% of menopausal women have one or both of these symptoms.
If you’re receiving treatment for breast cancer, a number of medicines can bring on early menopause and cause hot flashes and night sweats as a side effect.
Hot flashes and night sweats can be extremely bothersome for many people, affecting their quality of life, sleep, and stress levels.
Hormone replacement therapy (HRT), medicines that contain estrogen alone or estrogen combined with progesterone, increase hormone levels and are often used to treat hot flashes.
But people who’ve been diagnosed with breast cancer should not take HRT because estrogen and progesterone can fuel breast cancer growth. In addition, people with a history of heart disease, stroke, and blood clots shouldn’t take HRT.
About the position statement
Because a number of women can’t take HRT and other women prefer to use non-hormonal options to ease hot flashes, the NAMS asked an advisory panel to review the most current research on non-hormonal treatment options for hot flashes.
The advisory panel was made up of clinicians and researchers with special expertise in non-hormonal medical therapy, herbal therapy, behavioral therapy, and lifestyle approaches to treat hot flashes. Panel members reviewed research published since 2015.
The position statement recommends several non-hormonal options to ease hot flashes.
Cognitive behavioral therapy is a type of therapy that focuses on changing thinking and behavior patterns to help people better cope with a range of problems. Studies show that cognitive-behavioral therapy helps women see hot flashes as less of a problem.
Clinical hypnosis is a mind-body therapy that helps people enter into a deeply relaxed state of alertness so they can more easily make changes in their lives based on mental imagery and suggestion. It is widely used to manage pain and anxiety. Research shows that clinical hypnosis can reduce the number and severity of hot flashes.
Weight loss may decrease the number and severity of hot flashes, especially at the beginning of menopause, for some women.
Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), two types of antidepressant medicines, are linked to mild to moderate improvements in hot flashes.
Common SSRIs include:
Celexa (chemical name: citalopram)
Lexapro (chemical name: escitalopram)
Prozac (chemical name: fluoxetine)
Paxil (chemical name: paroxetine)
In 2013, the U.S. Food and Drug Administration (FDA) approved a low-dose formula of Paxil, sold under the brand name Brisdelle, to treat hot flashes.
Common SNRIs include:
Cymbalta (chemical name: duloxetine)
Effexor (chemical name: venlafaxine)
Savella (chemical name: milnacipran)
Gabapentin, a medicine used to treat epilepsy, also is commonly used to treat diabetes-related nerve pain. Research shows that it can reduce the number and severity of hot flashes.
Oxybutynin, a medicine used to treat overactive bladder syndrome, can ease moderate to severe hot flashes. Still, long-term use of oxybutynin has been linked to cognitive decline, especially in older people.
Veozah (chemical name: fezolinetant) was approved by the FDA in 2023 to treat hot flashes.
Stellate ganglion blockade, commonly called a nerve block, may ease moderate to very severe hot flashes.
The following therapies weren’t recommended:
paced respiration (slow, deep breathing)
supplements and herbs
exercise
yoga
soy products
cannabis
acupuncture
chiropractic manipulation
diet changes
clonidine (a blood pressure medicine)
Lyrica (chemical name: pregabalin)
cooling techniques
avoiding triggers, such as spicy food or alcohol
“Many women cannot or prefer not to take hormone therapy for hot flashes, but they are often unsure of what non-hormone options work and what doesn’t,” Chrisandra Shufelt, MD, said in a statement. Dr. Shufelt is a women’s health specialist at the Mayo Clinic and served as leader of the advisory panel. “Now, with help from this position statement, healthcare professionals can confidently guide women to effective non-hormone therapies and steer them away from inappropriate or ineffective therapies.”
What this means for you
If you have a history of breast cancer and are looking for a non-hormonal treatment for hot flashes, this position statement gives you a number of options.
You may want to take the position statement to your doctor and discuss the therapies that are best for you and your unique situation.
— Last updated on April 16, 2025 at 6:15 PM