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News
The American College of Physicians (ACP) now recommends hormone therapy as the first-line treatment for menopausal vasomotor symptoms like hot flashes and night sweats. The guidance, published in Annals of Internal Medicine, emphasizes shared decision-making and a tiered treatment approach. The move aligns with recent FDA label updates that removed longstanding safety warnings from several hormone therapy products.
The American College of Physicians (ACP) has issued new clinical guidance recommending hormone therapy as the first-line treatment for menopausal vasomotor symptoms — think hot flashes and night sweats. Published in Annals of Internal Medicine, the guidance strongly supports estrogen combined with progestogen (for women with a uterus) or estrogen alone (for those without), and arrives amid growing national attention on menopause care, including the first-ever U.S. Senate hearing on the topic.
The ACP also lays out a clear treatment ladder: SNRIs like venlafaxine as second-line options, and SSRIs, gabapentin, or neurokinin receptor antagonists (such as elinzanetant or fezolinetant) as third-line alternatives for those who can't tolerate earlier options. Clinicians are urged to proactively bring up menopause with patients and use shared decision-making to weigh benefits, risks, and individual preferences.
Key Takeaways:
Why it matters: This guidance gives clinicians a clearer, evidence-based roadmap for treating one of the most common and undertreated aspects of women's health — and it comes just as the FDA has already begun removing outdated safety warnings from hormone therapy labels, signaling a broader shift in how menopause care is approached.
