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Menopause · Updated 2026-05-17

Non-hormonal menopause treatments

Written byEditorial Team, HormonalHealth PortalReviewed byEditorial Medical Review, MD, NAMS-CMP· Updated May 17, 2026

Short answer: Paroxetine 7.5mg (only FDA-approved). Fezolinetant (Veozah) — NK3 antagonist, 60-65% VMS reduction. SSRIs/SNRIs off-label. Gabapentin for night sweats specifically.

1 min read

Key takeaways

  • Fezolinetant (Veozah) is the biggest non-hormonal advance in decades
  • SSRIs work but often delay-onset 4-6 weeks
  • CBT works alongside meds — synergistic

FDA-approved options

Paroxetine 7.5mg (Brisdelle) — only FDA-approved non-hormonal for hot flashes. Fezolinetant (Veozah) approved 2023. Both reduce VMS 30-50%.

Off-label evidence-based

Escitalopram, citalopram, venlafaxine — reduce VMS 50-70%. Gabapentin 300-900mg bedtime for night sweats specifically. Clonidine — older option, hypotension limits.

SC
Reviewed by Editorial Medical ReviewBoard-certified OB/GYN · NAMS-certified · Updated 2026-05-17

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