Non-hormonal treatments for hot flashes
This is not medical advice — it is general information based on what you searched for that may help.
General information based on published sources and the symptoms you searched for. This isn't medical or legal advice, a diagnosis or a treatment plan. Please consult a doctor about your own symptoms. If your symptoms are severe or sudden, seek urgent care.
Evidence:Strong evidence
Whether you have a medical contraindication to estrogen (such as a history of breast cancer or blood clots) or simply prefer a non-hormonal approach, you do not have to rely on unproven supplements. The Menopause Society's 2023 Nonhormone Therapy Position Statement grades the clinical trial evidence across prescription medications, behavioral therapies, and over-the-counter remedies for hot flashes and night sweats.
Guides in this section
- Veozah (fezolinetant): How this targeted NK3 receptor antagonist works, its Level I evidence, and its FDA boxed warning for liver blood test monitoring.
- Lynkuet (elinzanetant): What the OASIS 1–3 randomized trials showed for the dual NK1/NK3 receptor antagonist approved by the FDA in October 2025.
- SSRIs and SNRIs: Level I evidence, and the specific tamoxifen interaction to flag if you're on endocrine therapy.
- Gabapentin: Level I evidence, and why it's sometimes favored for nighttime symptoms.
- Oxybutynin: Levels I–II evidence, and who needs extra caution with this medication class.
- CBT and clinical hypnosis: Level I evidence with no drug interactions or systemic side effects.
- Does it work? Evidence checker: Filter every hormonal, non-hormonal, and supplement option by symptom and evidence grade.
Summary of guideline recommendations (NAMS 2023)
| Option | Evidence level | Guideline verdict for hot flashes |
|---|---|---|
| Fezolinetant (Veozah) & Elinzanetant (Lynkuet) | Level I / Phase 3 RCTs | Recommended targeted non-hormonal prescriptions; Veozah requires scheduled liver blood tests |
| SSRIs / SNRIs & Gabapentin | Level I | Recommended prescription options |
| Oxybutynin | Levels I–II | Recommended prescription option |
| CBT and clinical hypnosis | Level I | Recommended behavioral therapies that reduce hot flash bother and sleep disruption |
| Over-the-counter supplements & herbs (black cohosh, soy isoflavones, magnesium) | Levels I–II | Not recommended by guidelines for hot flashes |
Next steps
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Questions people ask
What are the most effective non-hormonal treatments for hot flashes?
In its 2023 Nonhormone Therapy Position Statement, The Menopause Society gives Level I recommendations to cognitive behavioral therapy (CBT), clinical hypnosis, SSRIs/SNRIs, gabapentin, and NK3 receptor antagonists such as fezolinetant (joined in October 2025 by FDA-approved elinzanetant), plus Level I–II support for oxybutynin.
Do over-the-counter menopause supplements work as well as non-hormonal prescriptions?
No. The Menopause Society (2023) reviewed randomized trials of over-the-counter herbal remedies and supplements and did not recommend them for hot flashes (Levels I–II) because results were inconsistent or no better than placebo.
Related pages
References
- Shufelt CL, Brown V, Carpenter JS et al.. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause (The North American Menopause Society, now The Menopause Society), 2023.
- VEOZAH (fezolinetant) tablets, prescribing information. Astellas Pharma US, 2026. Funding: Manufacturer-issued label (FDA-approved text).
- Bayer's Lynkuet (elinzanetant) approved in the U.S. for treatment of moderate to severe vasomotor symptoms due to menopause. Bayer, 2025. [Brand-funded] Funding: Manufacturer press release. Replace with the FDA label for efficacy and safety figures..
Change log
- : Published non-hormonal treatments sub-hub
- : Added links to 4 new child guides (SSRIs/SNRIs, gabapentin, oxybutynin, CBT/hypnosis)