Non-hormonal relief for hot flashes is real. In this episode of The Menopause Reset Podcast, hosts Susan and Karen outline evidence-based options when you prefer to avoid hormones or cannot use them. Clear, practical guidance you can discuss with your clinician.

What we cover

• Fezolinetant (NK3 receptor antagonist): how it works on the brain’s heat-control center, typical onset, common side effects, and why liver function tests are required.
• SSRIs/SNRIs at low doses for vasomotor symptoms: options such as paroxetine 7.5 mg (FDA-approved), venlafaxine, desvenlafaxine, citalopram, escitalopram. Onset, benefits, and sexual side effects to watch.
• Tamoxifen caution: avoid strong CYP2D6 inhibitors (for example paroxetine, fluoxetine). Ask about safer choices like venlafaxine, citalopram, or escitalopram.
• Gabapentin for night sweats: bedtime dosing strategy, drowsiness, and titration with a clinician.
• Older options: clonidine and oxybutynin, modest efficacy, anticholinergic effects, and when they may fit.
• Non-pill supports: cooler bedroom, breathable layers, warm shower 60–90 minutes before bed, caffeine by noon, wine with dinner not as a nightcap, two brief strength sessions weekly, short walks, CBT-I style strategies.

Appointment prep

• List your top symptoms and frequency across a week.
• Bring medical history and medication list, including tamoxifen or blood pressure meds.
• Note preferences such as night-focused support or willingness for liver tests with fezolinetant.
• Ask about time to benefit, common side effects, dose titration, and follow-up.

Tonight: cool your bedroom, set water and a small fan within reach, and try three slow breaths with longer exhales if you wake.

This week: discuss one medication with your clinician. If nights are worst, ask about gabapentin. If hormones are not an option, ask about fezolinetant or an SNRI. Track symptoms for 2–4 weeks before switching.

Rapid safety reminders: review your history and medications with a clinician; report concerning effects; complete ordered labs. Do not stop SSRIs or SNRIs abruptly. Follow liver test schedules with fezolinetant.

Keywords: non hormonal hot flash treatment, menopause hot flashes, night sweats, fezolinetant, NK3 receptor antagonist, SSRI, SNRI, paroxetine 7.5 mg, venlafaxine, desvenlafaxine, citalopram, escitalopram, gabapentin, clonidine, oxybutynin, vasomotor symptoms, menopause sleep, CBT-I, women over 40, women’s health podcast, The Menopause Reset Podcast.

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Next episode: Vaginal Dryness and Pain — moisturizers, lubricants, local vaginal estrogen, and pelvic floor PT for comfortable intimacy.

Disclaimer: This podcast is for informational purposes only and is not medical advice. Please consult your healthcare professional for personalized guidance.