Challenges in the Treatment of Vasomotor Symptoms: Update in Non-Hormonal Strategies

Abstract

Perimenopause and menopause per se significantly impacts on women quality of life (QoL), especially due to vasomotor symptoms (VMS); their duration is uncertain, and often long. Although menopause hormone therapy (MHT) is the most effective treatment for climacteric symptoms as a whole, its use is contraindicated in some cases. Therefore, it is mandatory that different treatment approaches be offered to women for whom hormone therapy is contraindicated. As for treatment selection, there are a wide range of nonhormonal options, both pharmacological and nonpharmacological. These options include alternative or natural therapies (isoflavones and Cimicifuga Racemosa), lifestyle modifications and complementary therapies. Regarding pharmacological strategies the literature review shows that serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), antihypertensives and anticonvulsants, decrease the intensity and frequency of VMS, proving a clinically significant improvement.