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  6. Hot Flushes Treatment - Pharmacological alternatives to Hormone Replacement Therapy (HRT), Gynaecology (1116)
Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits. 

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number.  To install latest updates:

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Please get in touch with ann.wales3@nhs.scot with any questions.

Hot Flushes Treatment - Pharmacological alternatives to Hormone Replacement Therapy (HRT), Gynaecology (1116)

Please report any inaccuracies or issues with this guideline using our online form

There are many reasons why women prefer not to take hormone replacement therapy (HRT). This may because they wish to deal with symptoms without hormonal medication, or that they feel the symptoms are not severe enough to justify treatment. In some cases however, HRT is not recommended due to a history of a hormone dependent cancer. In these situations, there are some alternatives that can be tried to help reduce the symptoms and allow the woman to cope through the menopause transition.

The medications listed here are primarily for the treatment of vasomotor symptoms.

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Editorial Information

Last reviewed: 14/11/2023

Next review date: 31/10/2027

Author(s): Dr Jenifer Sassarini, Consultant O&G.

Version: 1

Co-Author(s): Frances Lowrie, Specialist Pharmacist; Dr Claire Higgins, Consultant O&G.

Approved By: Gynaecology Clinical Governance Group

Document Id: 1116

References
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  2. Reddy SY, Warner H, Guttuso T, Jr., et al. Gabapentin, estrogen, and placebo for treating hot flushes: a randomized controlled trial. Obstetrics and gynecology 2006;108:41-8.
  3. Pandya KJ, Morrow GR, Roscoe JA, et al. Gabapentin for hot flashes in 420 women with breast cancer: a randomised doubleblind placebo-controlled trial. Lancet 2005;366:818-24.
  4. Guttuso T, Jr., Kurlan R, McDermott MP, Kieburtz K. Gabapentin's effects on hot flashes in postmenopausal women: a randomized controlled trial. Obstetrics and gynecology 2003;101:337-45.
  5. Clayden JR, Bell JW, Pollard P. Menopausal flushing: double-blind trial of a non-hormonal medication. British medical journal 1974;1:409-12.
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  7. Evans ML, Pritts E, Vittinghoff E, McClish K, Morgan KS, Jaffe RB. Management of postmenopausal hot flushes with venlafaxine hydrochloride: a randomized, controlled trial. Obstetrics and gynecology 2005;105:161-6.
  8. Handley AP, Williams M. The efficacy and tolerability of SSRI/SNRIs in the treatment of vasomotor symptoms in menopausal women: a systematic review. J Am Assoc Nurse Pract 2015;27:54-61.
  9. Johns C, Seav SM, Dominick SA, et al. Informing hot flash treatment decisions for breast cancer survivors: a systematic review of randomized trials comparing active interventions. Breast cancer research and treatment 2016;156:415-26.
  10. Stearns V, Slack R, Greep N, et al. Paroxetine is an effective treatment for hot flashes: results from a prospective randomized clinical trial. J Clin Oncol 2005;23:6919-30.
  11. Freeman EW, Guthrie KA, Caan B, et al. Efficacy of escitalopram for hot flashes in healthy menopausal women: a randomized controlled trial. Jama 2011;305:267-74.
  12. Leon-Ferre RA, Novotny PJ, Wolfe EG, et al. Oxybutynin vs placebo for hot flashes in women with or without breast cancer: a randomized, double-blind clinical trial (ACCRU SC-1603) JNCI Cancer Spectr, 4 (2019), Article pkz088