Skip to main content Scroll Top

Non-Hormonal Remedies for Hot Flashes and Night Sweats

For those that cannot or prefer not to use hormonal products, there are a range of pharmaceutical and non-pharmaceutical options.
Vasomotor symptoms (hot flashes and night sweats) have long been thought of as the hallmark symptom of perimenopause and menopause. However, research is starting to document a much broader range of symptoms. You will often hear: “Estrogen is the gold standard for menopause symptoms.” When you hear this it’s easy to think estrogen works for all symptoms but what this means is: Estrogen is the gold standard for hot flashes and night sweat or vasomotor symptoms.
Following from that, “non-hormonal remedies” tend to mean treatments for hot flashes and night sweats, but there are many other symptoms that are disruptive and can be treated as well. Some of these non-hormonal remedies for hot flashes and night sweats also help with other symptoms so we will try to be specific when that is the case.

Non-hormonal remedies include 3 types of strategies

  1. A new class of drugs made to specifically target hot flashes/night sweats
  2. Other prescription medications that are used “off-label” for hot flashes/night sweats and some other symptoms
  3. Behavioral or alternative treatments that might work for hot flashes/night sweats and some other symptoms

NK1/NK3 Inhibitors

There is a new type (“class”) of non-hormonal drug called NK1/NK3 inhibitors that were designed to reduce vasomotor symptoms. There are two products that are both once-a-day pills that act on the pathway in the brain that causes hot flashes and night sweats.

  • Fezolinetant (Veozah®) was approved by the FDA in 2023 for moderate to severe hot flashes.
  • Elinzanetant (Lynkuet®) was approved by the FDA in 2025 for moderate-severe hot flashes and sleep disturbance.
  • Similarities: Both agents target the KNDy pathway in the brain without hormones.
  • Differences: Veozah® has broader real-world data because it was approved earlier; Elinzanetant studied sleep and hot flashes in its trial. Liver function monitoring/testing through blood tests are required for both drugs but Veozah® requires more frequent testing.

Other Non-Hormonal Options

Other options according to the Menopause Society’s 2023 Non-Hormonal Position statement

Effective

Therapeutics

  • SSRIs/SNRIs
    • Escitalopram (Lexapro®)
    • Venlafaxine (Effexor®)
  • Gabapentin
  • Oxybutynin

Behavioral

  • Cognitive Behavioral Therapy (CBT)
  • Clinical hypnosis
  • Weight loss

Procedures/Treatments

  • Stellate ganglion bloc

Negative or insufficient evidence

Therapeutics

  • Suvorexant
  • Clonidine
  • Pregabalin

Behavioral

  • Paced respiration
  • Cooling techniques
  • Avoiding triggers (e.g. caffeine, alcohol, spicy foods)
  • Exercise
  • Yoga
  • Mindfulness-Based Interventions
  • Relaxation
  • Dietary modification

Over-the-Counter

  • Supplements/herbal remedies
  • Soy foods and soy extracts, soy metabolite equol
  • Cannabinoids

Procedures/Treatments

  • Acupuncture
  • Calibration of neural oscillations
  • Chiropractic interventions

Not harmful, work for some, worth trying

Although not supported or mentioned specifically by the Menopause Society’s 2023 position statement, the following work for some women so may be worth trying

  • Identify and avoid triggers
    • wine, sugar, alcohol
    • stressful thoughts
  • Dress in layers to be able to cool down quickly
  • Keep a small fan handy
  • Cooling techniques
    • Cooling sleep pads
    • Run hands under cold water
    • Keep an ice pack under your pillow
  • Paced breathing
  • Acupuncture

Something to note: In trials of nonhormone treatments of VMS (hot flashes and night sweats), the placebo effect is 20% to 66%. In addition, those with more anxiety show a higher placebo response.

REFERENCES

  1. Shufelt, et. al., The 2023 nonhormone therapy position statement of The North American Menopause Society. Menopause. 2023 Jun 1;30(6):573-590. doi: 10.1097/GME.0000000000002200. PMID: 37252752.