Two major medical groups are now on the same page about menopause care. Both ACOG and ACP recommend hormone therapy as the first-line treatment for hot flashes and night sweats, a significant shift from older, more cautious guidance. For women who can't take hormones, newer nonhormonal drugs and lifestyle options are also endorsed.
Two of medicine's biggest players — the American College of Obstetricians and Gynecologists (ACOG) and the American College of Physicians (ACP) — have both issued updated guidance putting hormone therapy (HT) front and center for managing menopause symptoms like hot flashes, night sweats, and sleep disturbances. ACOG's new guidance, released October 15, 2026, is its most comprehensive menopause advice yet, giving HT a "strong" recommendation and moving away from the old "lowest dose, shortest time" approach in favor of individualized, ongoing care.
Both organizations recommend starting HT before age 60 or within 10 years of menopause onset, with shared decision-making factoring in a patient's age, health history, and risks for breast cancer, cardiovascular disease, and blood clots. Where they differ slightly: ACP uses a more tiered approach for nonhormonal options, while ACOG takes a broader view that also addresses mood and sleep.
Key Takeaways:
Why it matters: Misconceptions about HT risks have long led to undertreatment of menopause symptoms, which affect up to 80–92% of women and can impact work, mental health, and quality of life. These updated guidelines from two leading bodies could meaningfully shift clinical practice and help millions of women get the care they need.
