EVIDENCE-BASED CLINICAL MEDICINE
Karina Atwell, MD, MPH; Morgan White, MD; Greta Kuphal, MD; Makeba Williams, MD; Sarina Schrager, MD, MS
Corresponding Author: Sarina Schrager, MD, MS; Department of Family Medicine and Community Health, University of Wisconsin
Email: sbschrag@wisc.edu
DOI: 10.3122/jabfm.2023.230408R1
Keywords: Menopause, Vasomotor Symptoms, Women's Health
Dates: Submitted: 11-08-2023; Revised: 03-20-2024; Accepted: 03-25-2024
FINAL PUBLICATION: |HTML| |PDF|
Vasomotor symptoms (VMS) related to the menopausal transition affect the majority of women and contribute to significant quality of life burden. Incidence, length, severity and report of symptoms vary by race, ethnicity, and coexisting health conditions. The pathophysiology of VMS is not fully understood and is likely multifactorial, involving changes in the hypothalamic-pituitary-ovarian axis during the menopausal transition. Treatment approaches include lifestyle modifications, hormonal and non-hormonal therapies, including integrative and complementary medicine approaches. Systemic hormone therapy with estrogen is the most effective treatment. Emerging evidence suggests that treatment with SSRIs, SNRIs, and gabapentin is effective for many women who want to avoid hormone therapy. A shared decision approach to treatment decisions involves consideration of risks with treatment options and discussion of patient priorities.