Non-hormonal therapies for menopausal symptoms with their mechanisms of action and clinical evidence
Non-hormonal therapy
Clinical evidence
Gabapentin
Modulates calcium channels in the central nervous system, reducing hot flashes [45]. Effective in reducing hot flashes and sleep quality, especially in women who cannot use estrogen therapy due to contraindications [43]
Alter serotonin levels to regulate body temperature. Approved for managing vasomotor symptoms, providing relief in non-hormonal therapy settings [43, 44]
Oxybutynin
Anticholinergic effects are commonly used for overactive bladder. It reduces sweating and hot flashes in postmenopausal women [43]
Fezolinetant
Neurokinin B receptor antagonist, modulating hypothalamic temperature control. Represents a new class of medications with promising efficacy in clinical trials [43]
Estrogen receptor modulation to reduce symptoms without systemic estrogen exposure. Bazedoxifene, when combined with conjugated estrogens, has been shown to provide benefits in reducing vasomotor symptoms while offering endometrial protection, making it a viable option for some women contraindicated for standard HRT [43]
Reduces body fat and stabilizes thermoregulatory mechanisms. Sustaining a healthy weight and engaging in physical activity can decrease hot flash frequency and intensity [44]
Cognitive behavioral therapy (CBT) and mindfulness-based interventions
Behavioral and psychological strategies for symptom management. Explored as effective non-hormonal strategies for alleviating menopausal symptoms [44]
HRT: hormone replacement therapy
Declarations
Acknowledgments
The authors thank Fatima M.A. Odhaib for her artistic contribution of Figure 1.
Author contributions
BAAS and SAO: Conceptualization, Investigation, Validation, Writing—original draft, and Writing—review & editing. Both authors read and approved the submitted version.
Conflicts of interest
The authors declare that there are no conflicts of interest.
Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.
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