Hormone Therapy Recommended for Menopausal Symptoms
The American College of Physicians now identifies hormone therapy as a primary option for managing hot flashes.
Updated on Oct. 5, 2026 in Women’s Health
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The American College of Physicians has issued new clinical guidance recommending hormone therapy as the first-line treatment for vasomotor symptoms during perimenopause. This shift comes as up to 80% of women experience these symptoms.
Why it matters
This guidance provides a new framework for patients and clinicians to manage hot flashes and night sweats, which affect the vast majority of women. It marks a shift toward prioritizing hormone therapy to address these daily symptoms.
The American College of Physicians utilized the Grading of Recommendations, Assessment, Development and Evaluation approach and systematic reviews to confirm hormone therapy as the preferred initial treatment. The organization evaluated both hormonal and non-hormonal pharmacological options.
The players
American College of Physicians
A national organization of internal medicine physicians that establishes clinical practice guidelines for the treatment of various health conditions.
Food and Drug Administration
The federal agency responsible for regulating medications and updating product labeling to reflect current safety evidence.
The details
The guidance identifies estrogen combined with progestogen or estrogen monotherapy as primary treatments to mitigate vasomotor symptoms. For those who cannot use hormones, the guidelines suggest serotonin-norepinephrine reuptake inhibitors as second-line options, followed by SSRIs, gabapentin, or neurokinin receptor antagonists as third-line therapies. These recommendations were developed through a rigorous review of treatment effectiveness, potential harms, and patient preferences.
Timeline
July 2025: The FDA removed cardiovascular, breast cancer, and dementia warnings from six hormone therapy products.
October 5, 2026: The American College of Physicians issued the new clinical guidance.
Health Landscape
The guidance aligns with the recent FDA hormone therapy product label updates by integrating the revised safety profiles of these treatments into routine clinical practice. This shift reflects an evolving clinical consensus on the benefit-risk profile of estrogen-based therapies for menopause.
If you are experiencing hot flashes or night sweats, this guidance supports discussing hormone therapy as an initial treatment option with your physician. Ensure you talk to your doctor about how your specific health history, including the updated FDA labeling, applies to your care.
The takeaway
Hormone therapy is now the first-line recommendation for managing common menopausal vasomotor symptoms. Patients should consult their primary care physician to review these updated treatment pathways against their own health profiles.
Further reading
For more information on navigating perimenopause, visit our guide on Women’s Health.
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Do you trust current clinical guidance regarding the safety and benefits of hormone therapy for menopause?
