What nonhormonal therapies are effective for postmenopausal vasomotor symptoms?
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Regular exercise may reduce vasomotor symptoms of menopause (strength of recommendation [SOR]: C—single observational study). Soy products/isoflavones, either through diet or supplementation, may reduce the incidence of hot flushes (SOR: D—inconsistent results of randomized trials). Clonidine, as an oral or transdermal preparation, reduces hot flushes (SOR: A—randomized clinical trials), as does gabapentin (SOR: A— single randomized clinical trial). In cancer patients who have had surgical menopause, selective serotonin reuptake inhibitors and megestrol (Megase) have been effective in reducing hot flushes (SOR: A; B for extrapolation to the general population). Other therapies—including Bellergal (a combination of belladonna, ergotamine, and phenobarbital), methyldopa, evening primrose oil, maiquan, flaxseed, ginseng, and topical wild yam extract—have not been effective. Black cohosh may be effective, but the evidence for this is of poor quality (SOR: C).
Journal of Family Practice, 52(4) 2003: 324-329.