ACP names hormone therapy first-line for menopausal hot flashes

The American College of Physicians published a new clinical guideline in Annals of Internal Medicine recommending estrogen-progestogen combination therapy (for those with a uterus) or estrogen monotherapy (for those without) as first-line treatment for menopausal vasomotor symptoms. For patients with contraindications to or intolerance of estrogen, ACP suggests SNRIs as second-line therapy, and SSRIs, gabapentin, or NK3 receptor antagonists as third-line options, while advising clinicians to use shared decision-making accounting for benefits, harms, comorbidities, and patient preferences.

Most relevant for: Perimenopausal and postmenopausal women experiencing hot flashes and night sweats, and the clinicians managing their symptom treatment.

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Informational only. Not medical advice. Not a substitute for clinical judgment. Always consult current guidelines and your own clinical judgment.