Guideline Developed for Treatment of Menopausal Vasomotor Symptoms

TUESDAY, Oct. 13, 2026 (HealthDay News) -- Recommendations are presented for the treatment of women with menopausal vasomotor symptoms in a clinical guideline issued by the American College of Physicians and published online Oct. 6 in the Annals of Internal Medicine.Amir Qaseem, M.D., Ph.D., from the American College of Physicians (ACP), and colleagues developed a clinical guideline for pharmacologic treatments for women with menopausal vasomotor symptoms. The guideline was based on systematic reviews on effectiveness, comparative effectiveness, harms, public and patient values and preferences, and economic evidence of pharmacologic treatments.For women seeking treatment of vasomotor symptoms, the authors recommend that clinicians initiate one of the following first-line treatments: estrogen in combination with progestogen in women with a uterus or estrogen monotherapy for women without a uterus (both based on high-certainty evidence). For women who have contraindications to or do not tolerate first-line treatment, clinicians are advised to use serotonin-norepinephrine reuptake inhibitors, either desvenlafaxine or venlafaxine, as second-line treatment based on moderate-certainty evidence. For women with contraindications to or who do not tolerate first- or second-line treatment, clinicians are advised to use selective serotonin reuptake inhibitors, either escitalopram or paroxetine; gabapentin; or neurokinin receptor antagonists, either elinzanetant or fezolinetant (based on low-, low-, and moderate-certainty evidence, respectively) as third-line treatments. An informed decision-making approach should be used when selecting a treatment, and benefits, harms, contraindications, comorbid conditions, and values and preferences should be discussed, as well as financial burden and access to and availability of treatments."The ACP provides a rigorous evidence synthesis that offers a strong foundation for individualizing treatment of menopausal women and clarifies evidence gaps that remain," Regina Castaneda, M.D., and Stephanie S. Faubion, M.D., from the Mayo Clinic in Jacksonville, Florida, write in an accompanying editorial.Clinical Practice GuidelineRelated Evidence Review (subscription or payment may be required)Editorial (subscription or payment may be required).Sign up for our weekly HealthDay newsletter

Guideline Developed for Treatment of Menopausal Vasomotor Symptoms

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