What to Know About Hormone-Free, Prescription Medications for Hot Flashes

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 alternative options, drug manufacturers have created several medications for hot flashes, including an FDA-approved, non-hormonal treatment – with another one in the works.

Here we’ll review some of the options for non-hormonal menopause symptom management and how they can help to reduce hot flashes.

Options for Hormone Free Hot Flash Relief

Historically, there have been few options for managing hot flashes without hormones. 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 Relizen®
• 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

The Scoop on FDA-Approved, Non-Hormonal Menopause Treatments for Hot Flashes

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

Other Options for Non-Hormonal Hot Flash Treatment

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’!

Those interested in a prescription-free, hormone-free, plant-based alternative to easing menopause hot flashes may consider supplemental options, such as Relizen. Relizen is composed of a proprietary blend of four Swedish flower pollens; it is hypothesized that Swedish flower pollen works to modulate your body's thermostat. Relizen has been clinically studied across multiple trials for both efficacy and safety – in fact, in a 12-week, open-label trial, women noted a 96% reduction in the number of hot flashes they experienced daily when consistently using this product.¹³ Relizen is completely hormone and phytoestrogen-free and does not work like a hormone in the body – which means it does not have any hormonal side effects.

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In addition to Relizen, women may also choose to explore other over-the-counter supplemental options to manage 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 Provider Can Help

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 treatments, 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. 

Title Tag: How Non-Hormonal Hot Flash Treatments Work | Bonafide

Resources

1. https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause
2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6780820/
3. https://www.goodrx.com/conditions/menopause/antidepressants-for-menopause
4. https://www.nhs.uk/conditions/menopause/things-you-can-do/
5. https://www.fda.gov/news-events/press-announcements/fda-approves-novel-drug-treat-moderate-severe-hot-flashes-caused-menopause
6. https://www.veozah.com/about-veozah
7. https://pubmed.ncbi.nlm.nih.gov/36924778/
8. https://www.rush.edu/news/how-body-regulates-heat
9. https://www.veozah.com/about-veozah
10. https://www.medicalnewstoday.com/articles/drugs-veozah#faq
11. https://www.health.harvard.edu/womens-health/fda-approves-first-drug-designed-to-treat-hot-flashes
12. https://www.mayoclinic.org/diseases-conditions/hot-flashes/diagnosis-treatment/drc-20352795
13. Elia D, Mares P. Genesis. 2008;135:12-15
14. https://www.webmd.com/menopause/ss/slideshow-menopause
15. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8102809/