Pharmacologic Treatments for Female Menopausal Vasomotor Symptoms: A Systematic Review and Meta-analysis for the American College of Physicians.

Estrogens and certain nonhormonal medications significantly reduce vasomotor symptoms and improve quality of life in menopausal women, with estrogens showing high economic value.

• Why it matters: Vasomotor symptoms are common and impactful during menopause, yet evidence on the benefits, harms, and cost-effectiveness of pharmacologic treatments remains limited, hindering informed decision-making.
• What they did: A systematic review and meta-analysis of 90 randomized trials evaluated the effects of various medications, including estrogens, progestogens, NKRAs, SNRIs, SSRIs, gabapentin, and oxybutynin, on VMS, quality of life, sleep, and adverse events.
• The result: Estrogens with or without progestogens effectively reduced VMS and enhanced quality of life, while NKRAs, SNRIs, and SSRIs improved VMS frequency, sleep, and QoL; harms data were limited, and long-term effects remain uncertain.