What is recommended
With good, consistent evidence, the 2023 position statement recommends:
- cognitive behavioural therapy and clinical hypnosis
- some prescription medicines: certain antidepressants (SSRIs/SNRIs), gabapentin and fezolinetant
With weaker evidence, it also lists oxybutynin, weight loss and a nerve block in the neck (stellate ganglion block). The NHS also describes behavioural therapy as helpful for hot flushes, low mood and sleep problems.
New medicines
Fezolinetant and elinzanetant act on a messenger in the brain that helps control body temperature. Elinzanetant has been approved in the EU since November 2025 and is under additional monitoring. Liver values are checked with both. Whether they're an option is for your doctor to decide.
What isn't recommended for hot flushes
For these, the statement found no sufficient benefit against hot flushes: herbal products and supplements, soy and soy extracts, acupuncture, cooling techniques, avoiding triggers, breathing exercises, yoga, mindfulness and exercise.
That doesn't mean exercise is pointless around menopause. It does a lot for strength, bones and heart (more on this). It just doesn't reliably reduce hot flushes according to current evidence. If a fan by the bed makes you feel better, you're not doing anything wrong. It just isn't proven.
And hormone therapy?
According to the same statement, it remains the most effective treatment and should be considered within the first ten years after the last period. More in the article on hormone therapy.