What medications help with hot flashes during menopause?

Stacy Wiegman, PharmD
Pharmacy Specialist

Various medications can help control hot flashes. You can talk to your doctor about getting a prescription for menopause hormone therapy (MHT), since hot flashes happen when your sex hormone levels fluctuate. MHT replaces enough of the estrogen (and sometimes the progesterone) that your body stops making during menopause to help prevent symptoms like hot flashes.

Not all women are candidates for MHT, however, and the drugs come with a long list of possible side effects. Ask your doctor about the risks and benefits of MHT.

Some antidepressants, anti-seizure drugs, blood pressure medicines, and mild sedatives also help with hot flashes, and you can talk to your doctor about whether those would be appropriate for you. Some women prefer to try herbal remedies and have had success with them. Again, talk to your doctor about whether these are safe and appropriate for you.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

When natural remedies aren’t enough, there are a few types of medication you can use to control hot flashes. Some are hormonal and some are not. The hormonal therapies are estrogen and progesterone and they can be given alone, or in combination with each other. Not everyone can take these because there are some concerning health effects in certain people or when they are given for a long time.

You can also take a non-hormonal medication. Some of these drugs are also used to treat depression and seizures, but have properties that help quell hot flashes too. These can be one of the selective serotonin-reuptake inhibitors (SSRIs), serotonin–norepinephrine reuptake inhibitors (SNRIs) or gabapentin. Non-hormonal therapies are a good option for women who cannot take hormones. However, it's worth noting that these drugs may not be approved by the Food and Drug Administration for the treatment of menopausal hot flashes. Only hormone therapies are FDA approved for this use. A conversation with your doctor can help evaluate what might work best for you.

Judy Caplan
Nutrition & Dietetics Specialist

Hormonal replacement therapy can control hot flashes. Although there has been concern over increased breast cancer rates in women who use hormonal replacement, studies show that women using it for five years or less do not suffer increased rates of cancer. Medication replaces the lost estrogen and controls the symptoms that come with decreasing levels. See your OBGYN for his or her recommendations on the pros and cons and recommended dosage.

Boston Women's Health Book Collective
Administration Specialist

Several prescription medications can help women control hot flashes. Their safety and effectiveness, however, vary. Hormone treatments can reduce the frequency and severity of hot flashes. Non-hormonal medications, such as antidepressants, antieleptics, and blood pressure medications are also helpful for some women, although they are not as effective.

Blood pressure medications work by decreasing the body's release of adrenaline and other hormones that increase blood pressure, heart rate, and anxiety or by stimulating the brain to send nerve signals to the blood vessels, making them relax and widen. Two blood pressure drugs have been studied for the treatment of hot flashes: clonidine (sold under the brand name Catapres) and methyldopa (sold under the brand name Aldomet). In randomized, double-blind, placebo-controlled trials, both medications helped to reduce the frequency of hot flashes by 46 to 80 percent in healthy women and those with breast cancer.

Our Bodies, Ourselves: Menopause

More About this Book

Our Bodies, Ourselves: Menopause

Patricia Geraghty, NP
Women's Health

The most effective treatment for hot flashes and night sweats is estrogen or estrogen plus progesterone for women who still have a uterus. It is safe and effective for women close to the age of menopause to use these hormones at low doses. The treatment alternatives of low dose antidepressants are supported by research as effective, but they are less effective than estrogen and progesterone. Anti-depressants may be alternate modalities for women who can't use estrogen. However, we should always start with the most effective intervention and ignoring the hormone therapy option may unduly alarm women.

The following medications can help with hot flashes that occur during menopause:

Antidepressant medication: The antidepressants venlafaxine (Effexor), fluoxetine (Prozac) and paroxetine (Paxil) may offer some relief for hot flashes. Antidepressants are not Food and Drug Administration (FDA)-approved for the treatment of hot flashes, however.

Cardiovascular medication: Low doses of the blood pressure drugs clonidine (Catapres) or methyldopa (Aldomet) may also help ease hot flashes in some women. These drugs are not FDA-approved for hot flashes, however, and unpleasant side effects are common. If you are interested in learning more about these medications, have a discussion with your health care professional.

The epilepsy and pain relief drug gabapentin has been shown to ease both the severity and the frequency of hot flashes by almost 50 percent. It may be the new best thing other than estrogen for the flash.

Also, a class of antidepressant drugs called SSRIs has been shown to reduce symptoms by 60 percent, as have alpha blockers such as clonidine (used to treat high blood pressure). All have side effects that many consider more problematic than estrogens, but some women prefer these choices.

I do not recommend clonidine because of the risk of rebound hypertension if it's abruptly discontinued. Patients are supposed to taper down use of the drug to avoid the side effects, but many patients don't comply with those rules, risking the chance of developing high blood pressure when they stop taking it suddenly.

You: Staying Young: The Owner's Manual for Extending Your Warranty

More About this Book

You: Staying Young: The Owner's Manual for Extending Your Warranty

International bestselling authors of YOU: The Owner's Manual and YOU: On a Diet give you all the tools and know-how to stay young and defy the ageing process. Drawing lively parallels between your...

Continue Learning about Menopause

All About Perimenopause
All About Perimenopause
Between mood swings and weight fluctuations, perimenopause can make you feel like a teenager again—and not necessarily in a good way. Hormonal changes...
Read More
What is natural menopause?
Dr. Michael Roizen, MDDr. Michael Roizen, MD
Natural menopause means that your periods have stopped naturally for at least a year. We make the di...
More Answers
8 Signs and Symptoms of Menopause
8 Signs and Symptoms of Menopause8 Signs and Symptoms of Menopause8 Signs and Symptoms of Menopause8 Signs and Symptoms of Menopause
Best Treatment for Menopause and Depression
Best Treatment for Menopause and Depression

Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.