Options without hormones

Who these are for

Hormone therapy is the most effective treatment for hot flashes, but some people can't take it for medical reasons, and some prefer not to. There are other options.

Medicines for hot flashes

• Some antidepressants can reduce hot flashes.¹
• Gabapentin, a seizure medicine, and clonidine, a blood pressure medicine, can reduce hot flashes and help with sleep problems.¹
• Fezolinetant (Veozah), approved by the FDA in 2023, blocks a receptor in the brain involved in controlling body temperature. It's a daily pill for moderate to severe hot flashes. It needs liver blood tests before starting and regularly in the first months, and it isn't for people with cirrhosis or severe kidney disease.²
• Elinzanetant (Lynkuet), approved by the FDA in October 2025, is another non-hormone medicine for moderate to severe hot flashes, taken at night.³

Vaginal dryness without hormones

Over-the-counter vaginal moisturizers, used every 2 to 3 days, and lubricants used during sex can ease dryness and pain. They don't contain hormones, so they don't change the thickness or stretch of the vaginal walls.¹

Myth: Natural supplements are a safe, proven fix for menopause.

Products like soy, black cohosh and herbal blends are widely sold, and it's easy to assume "natural" means safe and tested. Only a few have been studied for safety and effectiveness, and how they're made isn't regulated, so there's no guarantee of what's in them or how much.¹ If you take one, tell your doctor.

Lifestyle

Regular exercise slows bone loss and helps overall health, strength training builds muscle and bone, and balance training like yoga or tai chi may help prevent falls.¹ Getting enough calcium and vitamin D supports bones.¹

Questions to ask

• Which non-hormone option fits my symptoms and health?
• What monitoring would I need?
• Would a vaginal moisturizer or local estrogen help my dryness?