The North American Menopause Society Advisory Panel has announced the release of their 2023 position statement on nonhormonal therapy for menopause.
The North American Menopause Society’s (NAMS) 2023 Nonhormone Therapy Position Statement detailing recommendations on the use of nonhormone therapies to manage menopause symptoms has been published in Menopause, the official journal of NAMS.1
A NAMS Advisory Panel is comprised of clinician-researchers with special expertise in nonhormone medical therapy, behavioral therapy, herbal therapy, and lifestyle managements for vasomotor symptoms (VMS) developed the statement. Literature on nonhormonal therapies published since the previous Position Statement in 2015 were reviewed by the panel when designing recommendations.
“Many women cannot or prefer not to take hormone therapy for hot flashes, but they are often unsure of what nonhormone options work and what doesn’t,” said Chrisandra Shufelt, MD, MS, NCMP, FACP, lead of the Advisory Panel for the 2023 Nonhormone Therapy Position Statement.
“Now, with help from this Position Statement, health care professionals can confidently guide women to effective nonhormone therapies and steer them away from inappropriate or ineffective therapies,” Shufelt added.
Several nonhormonal options were recommended, such as clinical hypnosis, cognitive-behavioral therapy, stellate ganglion blockade, weight loss, selective serotonin reuptake inhibitors, oxybutynin (Ditropan XL; Novitium Pharma), and gabapentin (Neurontin; Pfizer). Fezolinetant (VEOZAH; Astellas Pharma), a new FDA-approved treatment , was also analyzed.
The panel did not recommend herbal remedies, cooling techniques, paced respiration, exercise, yoga, avoiding triggers, mindfulness-based intervention, soy products, relaxation, suvorexant, cannabinoids, calibration of neural oscillations, acupuncture, chiropractic interventions, dietary modification, clonidine, or pregabalin for treating menopause symptoms.
Investigators concluded hormone therapy is still the most effective treatment for VMS.2 These therapies should be front-line treatment for women within 10 years of their final menstrual cycle. Health care professionals should remain informed on evidence-based nonhormonal options to treat VMS in women with contraindications or personal preference preventing the use of hormonal treatment.
“The good news for women is that there are many options available for the treatment of bothersome hot flashes, including several nonhormone therapies,” said Stephanie Faubion, MD, MBA, medical director of NAMS.1 “We also have a better understanding of what is not effective so that women and healthcare professionals can target therapies that have been proven to work.”
1. The North American Menopause Society releases its 2023 Nonhormone Therapy Position Statement. EurekAlert. June 1, 2023. Accessed June 5, 2023. https://www.eurekalert.org/news-releases/991125
2. The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023;30(6):573-590. doi:10.1097/GME.0000000000002200