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Cognitive behavioral therapy, clinical hypnosis, SSRIs/serotonin-norepinephrine reuptake inhibitors recommended based on level I evidence.

In a position statement issued by the North American Menopause Society and published online June 1 in Menopause, updated recommendations are presented for the nonhormonal management of menopause-associated vasomotor symptoms.

Chrisandra L. Shufelt, M.D., from the Mayo Clinic in Jacksonville, Florida, and colleagues updated the evidence-based Nonhormonal Management of Menopause-Associated Vasomotor Symptoms: 2015 Position Statement for the North American Menopause Society. An advisory panel reviewed and evaluated the literature published since the 2015 position statement.

The authors identified several nonhormone options for treatment of vasomotor symptoms in an evidence-based review of the literature. Cognitive behavioral therapy, clinical hypnosis, selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors, gabapentin, and fezolinetant were recommended based on level I evidence; oxybutynin was recommended based on levels I to II evidence; and weight loss and stellate ganglion block were recommended based on levels II to III evidence. Paced respiration was not recommended based on level I evidence; supplements/herbal remedies were not recommended based on level I to II evidence; and cooling techniques, avoiding triggers, exercise, yoga, mindfulness-based intervention, and relaxation were also included as therapies that were not recommended (level II evidence).

“The good news for women is that there are many options available for the treatment of bothersome hot flashes, including several nonhormone therapies,” Stephanie Faubion, M.D., medical director of the North American Menopause Society, said in a statement. “We also have a better understanding of what is not effective so that women and health care professionals can target therapies that have been proven to work and avoid the wasted time, energy, and expense associated with ineffective or unproven remedies.”

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Several authors disclosed ties to the pharmaceutical industry.

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