Hot Flashes in Menopause When Non-Hormonal Prescription Medications Have Not Worked — Estrogen Contraindicated

Clinical Scenario

This protocol addresses postmenopausal women with vasomotor symptoms (hot flashes) in whom estrogen therapy is contraindicated, and for whom first-line non-hormonal prescription medications have not adequately controlled symptoms.

Previous Step — Goal Not Achieved

The preceding treatment line used non-hormonal prescription medications. The target for that line — reduction of vasomotor symptoms (hot flashes) — was not sufficiently met, making escalation to this protocol appropriate.

Next-Step Approach (Partial)

This protocol draws on complementary and alternative medicine, including certain plant-derived preparations that have been studied for vasomotor symptoms — though efficacy in this category is not established. The full structured regimen is in the protocol.

Instant Access to Structured Evidence-Based Regimens

References

Progestogens alone may be used in women with contraindications to estrogen therapy.

If these strategies are ineffective or unacceptable, complementary and alternative medicine may be used, although efficacy is unproven.

Phytoestrogens comprise two major categories: (1) isoflavones (particularly genistein), which have shown benefit in treating mild vasomotor symptoms, and (2) flaxseed, which has not.

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