Navigating Menopause with Medicine

A Women’s History Month Feature

Summary

• Menopause is a natural stage in a woman’s life marked by the permanent end of menstrual periods, typically occurring between ages 40 and 50, and is accompanied by various symptoms such as hot flashes, mood changes, and sleep problems.
• Recent FDA-approved medications, including Veozah® (fezolinetant) and Lynkuet® (elinzanetant), target neurokinin receptors in the brain to effectively treat moderate to severe hot flashes during menopause.
• Alternative treatments for hot flashes include anti-seizure medications like gabapentin and pregabalin, offering additional options for symptom relief during menopause.

What is menopause? 

Menopause is the stage of a woman’s life when menstrual periods stop permanently for at least 12 consecutive months, and she can no longer get pregnant. Menopause is a natural part of aging for women. The average age for menopause to occur for American women is 51 but can happen from the 40s to 50s. About 2 million American women enter menopause every year.

The time leading up to menopause is called perimenopause. During perimenopause, menstrual cycles become less regular and are spaced farther apart. Many women also experience menopausal symptoms during perimenopause.

Some symptoms of menopause include hot flashes, night sweats, brain fog, mood changes, sleep problems, and vaginal dryness.

Medications for hot flashes

During menopause, estrogen levels drop and this drop can cause the body’s internal thermostat to get out of balance. That can trigger vasomotor symptoms, also known as hot flashes. About 75% of women experience hot flashes during menopause.

In May 2023, the FDA approved Veozah® (fezolinetant), an oral medicine to treat hot flashes. Veozah was the first neurokinin 3 (NK3) receptor antagonist approved by the FDA to treat moderate to severe hot flashes from menopause. The drug binds and blocks the activities of the NK3 receptor, which has a role in the brain’s regulation of body temperature.

Another drug for hot flashes, Lynkuet® (elinzanetant), was approved in October 2025. Lynkuet blocks neurokinin 1 (NK1) and NK3 receptors, receptors in the brain that help to control body temperature. The drug is the first to target both NK1 and NK3.

There are some other medicines that can work on hot flashes, too. These include:

1. Gabapentin, an anti-seizure medication.
2. Pregabalin, an anti-seizure medication.
3. Oxybutynin, a pill or patch used to treat some urinary conditions.
4. Clonidine, a pill or patch to treat high blood pressure.

Additionally, low doses of some antidepressants can be helpful. These include:

1. Escitalopram.
2. Paroxetine.
3. Venlafaxine.
4. Citalopram. 

Hormone therapy

Hormone therapy (HT) can also be helpful for women managing menopause symptoms. Black box warnings were included on HT for many years, which may have affected the number of women choosing to use it. But in November 2025, the FDA announced it would remove these warnings from HT products that contain estrogen.

According to the FDA, there are several types of HT:

1. Combination therapy, which combines doses of estrogen and progestin or progesterone (for women with a uterus).
2. Systemic estrogen-alone therapy, which has only estrogen. This is often used in women who don’t have a uterus, but can be used in women with a uterus in concert with progesterone-alone therapy.
3. Progestogen-alone therapy, which contains only progesterone or progestin. This can be added to systemic estrogen-alone therapy for women with a uterus.
4. Topical vaginal estrogen therapy, which is estrogen applied to the vaginal area for the treatment of vaginal symptoms.

Prescriptions for hormone therapy went up by 86% between 2021 and 2025. Estrogen patches are currently in shortage in part due to this rise in demand. Estradiol patches went into shortage on January 30, 2026, according to the American Society of Health System Pharmacists.

Final thoughts

There are more available options nowadays to treat menopause symptoms. Determining which medicine to take is a very personal decision, one that should be discussed with a healthcare provider. With the right support and treatment, menopause symptoms can be more comfortably controlled and tolerated.

Disclaimer: The foregoing does not constitute medical advice. Always consult with a qualified and licensed physician or other medical professional.

References

The Menopause Years. American College of Obstetricians & Gynecologists.

Perimenopause. Mayo Clinic.

Menopause. Mayo Clinic.

Carter, Beth. Women in Menopause Often Go Untreated. AARP Policy Institute. April 17, 2025.

FDA Approves Novel Drug to Treat Moderate to Severe Hot Flashes Caused by Menopause. Food & Drug Administration. May 12, 2023.

Cohen, Sandy. Hot flashes and more: New program helps patients through menopause. UCLA Health. October 3, 2023.

Lynkuet FDA Approval History. Drugs.com. October 25, 2025.

Hot flashes. Mayo Clinic.

Stubbs, Chris, Mattingly, Lisa, Crawford, Steven A. et al. Do SSRIs and SNRIs reduce the frequency and/or severity of hot flashes in menopausal women. Journal of the Oklahoma State Medical Association. May 2017.

Salamon, Maureen. FDA removes menopause hormone therapy black box warnings. Harvard Health Publishing. Harvard Medical School. November 13, 2025.

Hormone Replacement Therapies Can Help Women with Bothersome Menopausal Symptoms. Food & Drug Administration. February 13, 2026.

Agrawal, Nina. The Estrogen Patch Surged in Popularity. It’s Now in Shortage. The New York Times. February 26, 2026.

Drug Shortages List. American Society of Health System Pharmacists.