Hormonal therapy recommended as a first-line treatment for menopausal vasomotor symptoms
The American College of Physicians (ACP) recommends estrogen in combination with progestogen (for females with a uterus) or estrogen monotherapy (for females without a uterus) as first-line treatment for perimenopausal and postmenopausal females experiencing menopausal vasomotor symptoms (VMS), which consist of hot flashes and night sweats. ACP's new clinical guideline is published in Annals of…
The American College of Physicians (ACP) has released a clinical guideline recommending estrogen therapy as the first-line treatment for menopausal vasomotor symptoms (VMS) in women, both during perimenopause and postmenopause. VMS, which include hot flashes and night sweats, affect up to 80% of women and can significantly impact quality of life. The guideline suggests that estrogen combined with progestogen is optimal for women with a uterus, while estrogen alone is recommended for those without a uterus.
For women who cannot or do not want to use estrogen therapy, the ACP advises second-line treatments such as serotonin-norepinephrine reuptake inhibitors (SNRIs) like desvenlafaxine or venlafaxine, or selective serotonin reuptake inhibitors (SSRIs) such as escitalopram or paroxetine. Gabapentin or neurokinin receptor antagonists (e.g., elzanetant or fezolinetant) can be considered as third-line options.
The guideline encourages physicians to engage in informed decision-making when selecting treatments, taking into account patients' individual benefits, risks, and preferences.
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