Gamot sa menopause na hindi hormone: what actually works

Maybe you have had breast cancer or a blood clot. Maybe your OB said no to HRT. Maybe you just prefer not to take hormones. All valid. Hormone therapy is still the most effective treatment for hot flashes (The Menopause Society 2022), so if you have simply been told it "causes cancer", read HRT for menopause first. But a good non-hormonal plan can make a big difference.

Everything below is rated using The Menopause Society 2023 nonhormone therapy position statement, the main review of non-hormonal options for vasomotor symptoms (hot flashes and night sweats), plus NICE NG23 (2024 update) where it adds to it. Ratings use our site labels: Strong evidence, Some evidence, Limited evidence, Not enough evidence and Not recommended.

All the medicines here need a prescription in the Philippines. We list prices so you can plan, not so you can self-treat. Your doctor chooses the medicine and dose.

Paroxetine and other SSRIs and SNRIs. Strong evidence. These antidepressant-family medicines reduce hot flashes even in women without depression. Low-dose paroxetine (7.5 mg) was the first non-hormonal medicine approved for hot flashes in the US; fezolinetant is now the second. Escitalopram, citalopram, venlafaxine and desvenlafaxine also reduced hot flashes in large trials (Menopause 2023). Bonus: they can help mood and anxiety too. Common side effects include nausea, sleepiness or sleeplessness, and lower libido. Paroxetine (and fluoxetine) can block the enzyme that turns tamoxifen into its active form, so with tamoxifen the statement names venlafaxine, desvenlafaxine, escitalopram or citalopram as safer choices. In the PH: paroxetine (Seroxat) 20 mg, ₱68.75 per tablet (Watsons). More on paroxetine for hot flashes.

Gabapentin. Strong evidence. A nerve-pain and seizure medicine that also lowers hot flashes. Because it causes drowsiness and dizziness, doctors often give it at bedtime, which suits women whose main problem is night sweats and broken sleep. In the PH: gabapentin (Reinin) 300 mg, ₱42 per capsule (Watsons). More on gabapentin for hot flashes.

Fezolinetant. Strong evidence, but not sold in the PH. A newer non-hormonal tablet that acts on the brain's temperature centre, approved in the US in May 2023. The 2023 statement recommends it (Level I). We found no Philippine FDA registration or PH retailer listing: Not available in PH retail as of October 2026. Its US label asks for liver blood tests before starting and several times in the first 9 months. See fezolinetant.

Oxybutynin. Some evidence. A bladder medicine that also reduces sweating and hot flashes. The 2023 statement recommends it, but notes that long-term use of anticholinergic medicines like this may be linked to cognitive decline, particularly in older people. Dry mouth and trouble passing urine are the most common side effects. It may also help if you have an overactive bladder. We have not checked a PH price yet.

Prices checked October 2026. For a monthly cost, use the cost calculator.

Cognitive behavioural therapy (CBT). Some evidence. CBT does not make hot flashes disappear, but it reduces how much they bother you and improves sleep. NICE 2024 found CBT can help hot flashes, night sweats, sleep problems and low mood in menopause. In the PH, ask a psychologist or psychiatrist whether they offer CBT for menopause symptoms, in person or online.

Clinical hypnosis. Strong evidence. Guided hypnosis sessions with a trained clinician reduced hot flashes in trials and are recommended in the 2023 statement. We have not found a directory of trained providers in the PH, so ask your doctor or a psychologist for a referral.

Weight loss. Limited evidence. The 2023 statement lists weight loss as recommended for hot flashes, with limited evidence. Losing weight also helps blood pressure, blood sugar and joints. See weight and belly.

Stellate ganglion block. Limited evidence. An injection of local anaesthetic near a nerve bundle in the neck, done by a pain specialist. The 2023 statement says it might help moderate to very severe hot flashes in selected women, including breast cancer survivors, but larger trials are still needed. It is a procedure with rare risks, not a first step. We could not confirm which PH centres offer it for hot flashes.

The 2023 statement reviewed these and did not recommend them as hot flash treatments:

• Herbal remedies such as black cohosh, evening primrose, red clover, dong quai and multi-herb "menopause formulas"
• Soy foods and soy extracts, including isoflavone capsules
• Paced breathing
• Cooling techniques such as fans and cold drinks
• Avoiding triggers
• Exercise and yoga, for hot flashes specifically
• Acupuncture
• Clonidine and pregabalin

"Not recommended for hot flashes" is not the same as "bad for you". Exercise is great for your heart, bones, mood and sleep. A fan at your desk is comfort, and you deserve comfort. They are just not treatments that reliably reduce hot flashes. For honest ratings of every popular brand at Watsons, see menopause supplements, rated.

The 2023 statement is about hot flashes and night sweats. Other menopause symptoms have their own best options, and some of them are low-dose hormones that act only where they are applied:

• Vaginal dryness and painful sex: vaginal estrogen is a local treatment with very little reaching the blood, and NICE 2024 says it can be offered for as long as needed. Non-hormonal moisturisers and lubricants help comfort. See vaginal dryness and vaginal estrogen.
• Bone loss: besides HRT, there are non-hormonal bone medicines such as alendronate, plus calcium, vitamin D and strength training. See bone loss.
• Low mood and anxiety: CBT has evidence (NICE 2024), and antidepressants are standard care when depression or an anxiety disorder is diagnosed.
• Sleep: CBT for insomnia comes first. See sleep.

A quick guide to start the conversation:

• Hot flashes plus low mood or anxiety: an SSRI or SNRI may help both. See mood and anxiety.
• Mostly night sweats and poor sleep: gabapentin at night, or CBT for insomnia.
• Hot flashes plus bladder urgency: oxybutynin may fit, with caution if you are older.
• History of breast cancer: talk with your oncologist; paroxetine is avoided with tamoxifen.
• You would rather not take pills: CBT or clinical hypnosis.

Bring your symptom record. The symptom checker and symptom diary make a one-page summary. If your OB will not discuss options, find a doctor lists menopause-literate OB-GYNs and teleconsults, and talk to your doctor has scripts in Taglish. Read more about hot flashes.

Some symptoms need a doctor before any treatment: bleeding after menopause, a new breast lump, chest pain, a swollen painful leg or a sudden severe headache. If an antidepressant leaves you feeling much worse, agitated or having thoughts of self-harm, contact your doctor straight away or call the NCMH crisis hotline: 1553 (landline), 0919-057-1553 (Smart/TNT), or 0917-899-8727 or 0966-351-4518 (Globe/TM), free and 24/7. See bleeding after menopause.