Hormone-Free Prescription Solutions for Hot Flashes: What to Know

5 min read

Written By

Brittany Dick

Published

June 26, 2026

Medically reviewed by

Alyssa Dweck MS, MD, FACOG, MSCP, Chief Medical Officer

When ranking the most common menopause symptoms, hot flashes often make it to the top of the list; with around 75% of women reporting these notorious, sudden, often brief increases in body temperature and perspiration during menopause and perimenopause.¹

Though hormone replacement therapy has existed for decades as an option to manage the many symptoms of menopause, not all women navigating this transitional period are candidates, and others may be interested in exploring different forms of hormone-free, hot flash relief.² For those looking for hormone-free treatment for hot flashes, drug manufacturers have created several medications for this symptom, including one of the FDA-approved, hormone-free solutions available on the market today.

Here we’ll review some of the options for alternatives to hormone therapy for menopause and how they can help to reduce hot flashes.

Non-Hormonal Treatment for Hot Flashes

Historically, there have been few options for hormone-free menopause solutions for hot flashes. However, as more research is dedicated towards women’s health, treatment methods continue to grow and evolve. They currently include:

FDA-approved, non-hormonal menopause hot flash prescriptions (that work through non-hormonal pathways in the body…more on that later)
Plant-based, phytoestrogen-free supplements, such as Thermella®
Other phytoestrogen-based supplements or over-the-counter options
Antidepressants, such as selective serotonin-reuptake inhibitors (SSRIs)³
Diet and lifestyle adjustments shown to help manage menopause symptoms⁴

FDA-Approved Menopause Solutions That Are Hormone-Free

In May 2023, the U.S. Food and Drug Administration approved Veozah^TM as a first-of-its-kind, oral medication for menopause hot flash treatment.⁵ But what exactly is Veozah, and how does it claim to treat symptoms? Here’s what the research says.

What is Veozah?

Veozah, known generically as fezolinetant, is an FDA-approved, hormone-free menopause treatment used to manage moderate to severe menopausal hot flashes and night sweats.⁶

Across multiple clinical trials funded by Astellas Pharma—the manufacturer of Veozah—fezolinetant was shown to reduce the severity and frequency of these vasomotor symptoms in as little as four weeks.⁷ While clearly effective, this drug option is not covered by all insurance providers, so it may be cost prohibitive for some women.

How Does Veozah Work?

This medication works directly in the hypothalamus, the part of your brain that acts as the body’s thermostat, working to regulate temperature throughout the body.⁸ Here, it blocks neurokinin B (NKB), a chemical that binds to a brain receptor that’s known to trigger menopausal hot flashes and night sweats.⁹

Precautions to Consider with Veozah

As with most prescription medications, Veozah may not be right for all women. Women with the following contraindications should consider exploring alternative options for hot flash relief, as well as thoroughly discussing this medication with a healthcare provider before trying it for the mitigation of their symptoms:¹⁰

Liver conditions, such as cirrhosis
Kidney conditions, such as kidney failure
A history of allergic reactions to similar drugs
Utilizing a current regimen of medications that negatively interact with Veozah
Those who are pregnant or breastfeeding

Due to its potential side effects, women taking Vezoah must also undergo routine blood tests to screen for signs of liver damage when using this product.¹¹

Prescriptions for Hot Flashes: Other Hormone-Free Menopause Treatment Options

In addition to Veozah, other prescription medications are available through your healthcare provider to help mitigate hot flashes and night sweats during menopause. These can include:¹²

Gabapentin: an anti-seizure medication that’s been shown to help ease menopausal hot flashes
Oxybutynin: a prescription that comes in a pill/patch format that is more commonly used to address urinary conditions. It’s been shown to potentially help address vasomotor symptoms in menopause
Clonidine: another type of pill/patch that is often used to treat high blood pressure, which has also been shown to reduce hot flashes and night sweats
As mentioned, certain antidepressants may also be prescribed to help lessen hot flashes and night sweats during menopause

But besides prescription options and adjustments in diet and lifestyle, are there any other management options for women looking for hormone-free, hot flash relief?

Fortunately, the answer is ‘yes’!

For women looking for a hormone-free management option to ease disruptive vasomotor symptoms, Bonafide’s Thermella may be right for you. It’s a dietary supplement clinically studied to reduce the frequency and intensity of menopausal hot flashes and night sweats at the source.* Thermella is formulated with clinically studied ingredients designed to work with the body’s natural temperature regulation processes, without the use of hormones.

Because Thermella is hormone-free, it does not cause hormonal side effects in the body. When used consistently and as directed, women may experience relief from the frequency and intensity of menopause-related hot flashes and night sweats.¹³

In addition to Thermella, women may also choose to explore alternatives to hormone therapy for managing menopause symptoms like hot flashes, such as black cohosh, red clover, wild yam, soy, DHEA, flax seed or evening primrose – however, clinical data is limited regarding the efficacy of these supplements.^{14, 15}

We strongly recommend checking-in with your healthcare provider first before incorporating any of these supplements into your daily routine, as some may be considered to be phytoestrogens, which could have hormonal impacts in the body.

Talking to A Healthcare About Hot Flashes

If hot flashes and night sweats are disrupting your days and nights during menopause, you’re not alone.

If you’re interested in exploring non-hormonal hot flash solutions, a conversation with a trusted healthcare provider can help you decide which options to consider trying. A physician will also be able provide considerations based on your health status, medical history, and treatment goals to help you narrow down to an option that’s right for you.