Best Non-Hormonal Menopause Treatments

The best non-hormonal treatments for menopause hot flashes and night sweats are two newer prescription pills, Veozah (fezolinetant) and Lynkuet (elinzanetant). Both block a brain signal that sets off hot flashes, and both cut hot flashes more than placebo in trials. No study has compared the two directly, so the right one for you depends on which side effects, blood tests and daily routine fit your life.

Which non-hormonal treatment works best for hot flashes?

Veozah and Lynkuet are the strongest non-hormonal choices. They belong to a new group of pills called neurokinin blockers. They act on brain cells that help control body temperature and are involved in hot flashes, as Lynkuet's prescriber information explains. Neither one is a hormone.

The North American Menopause Society's 2023 guidance recommends fezolinetant (Veozah) for hot flashes and says the evidence for it is good and consistent. It gives the same rating to antidepressants called SSRIs and SNRIs, gabapentin, CBT (a structured form of talk therapy) and clinical hypnosis.

Here is how much each new pill helps. In a 2025 analysis that pooled the placebo-controlled trials, women on Veozah 45 mg had about 2.5 fewer moderate to severe hot flashes a day than women on placebo. Women on Lynkuet 120 mg had about 3 fewer a day than placebo.

In Lynkuet's two main trials, women started with about 13 to 15 moderate to severe hot flashes a day. By week 12, they had about 9 to 10 fewer a day. Women on placebo had about 5 to 6 fewer. The difference was already clear at week 4.

The analysis found a bigger effect for Lynkuet, but it compared each drug with placebo in separate trials, not with each other. Researchers say head-to-head trials are still needed, so no one can say yet that one beats the other. The useful question is which one suits your body and your routine.

Should I take Veozah or Lynkuet?

Choose by the trade-off you would rather live with. Veozah means regular liver blood tests through your first 9 months. Lynkuet means a bedtime dose that can leave some women drowsy.

Veozah and your liver. In the pooled Veozah trials, liver enzyme rises (a blood test sign that the liver is under strain) showed up in 2.3% of women on the 45 mg dose, compared with 0.9% on placebo. They usually caused no symptoms and went away, either while women kept taking it or after they stopped. That is why the testing schedule matters. Stop Veozah right away and call whoever prescribed it if you notice yellow eyes or skin, dark urine, pale stools, nausea or unusual tiredness.

Lynkuet and drowsiness. In a year-long study, women on Lynkuet had more fatigue (7.3% vs 2.9% on placebo), dizziness (6.1% vs 1.9%) and sleepiness (5.1% vs 1.3%), according to the Lynkuet prescriber FAQ. The label warns about daytime impairment. Some women's driving was impaired 9 hours after their first dose, so don't drive the next morning if you feel foggy. The bedtime dose works in your favor if hot flashes keep waking you, since Lynkuet improved sleep quality in the trials.

More on who should skip Lynkuet. If you could still get pregnant, you need a negative pregnancy test before starting. You also need effective birth control while you take it and for 2 weeks after you stop. Avoid grapefruit juice and strong CYP3A4 inhibitors, a group of medicines that interact with it, so bring your full medication list to whoever prescribes it. Women with a history of seizures should use it with caution.

Who these pills were tested in. Veozah's trials enrolled postmenopausal women aged 40 to 65 who averaged at least 7 moderate to severe hot flashes a day. If yours are frequent and disruptive, you look like the women these pills were built for.

How much do Veozah and Lynkuet cost?

What you pay depends mostly on your insurance. Veozah is brand-only, with no generic yet.

With commercial insurance, the Veozah Savings Card can bring your first month to $0 and refills to as little as $30, with a $4,000 yearly cap. It doesn't work with government insurance, such as Medicare or Medicaid, or if you pay cash. Uninsured women who qualify may pay $0 through the Astellas Patient Assistance Program.

Lynkuet's copay program can bring the cost to as little as $25 a month if you have commercial insurance. The maker notes that not every commercial plan may cover Lynkuet right away.

Your insurer may want a prior authorization, a request your prescriber sends before the plan agrees to pay. Veozah's insurance tips suggest telling your prescriber what you have already taken for hot flashes. Keep that list handy, because it can help get the claim approved.

Do antidepressants, gabapentin or supplements work for hot flashes?

Antidepressants and gabapentin help some women, but most give milder relief than the newer pills. Supplements are not recommended.

Low-dose antidepressants (SSRIs and SNRIs, including an FDA-approved low-dose paroxetine), gabapentin, pregabalin and oxybutynin are all prescription options. A pharmacist review found that most give only mild to moderate relief. The same review found that fezolinetant cut hot flash frequency significantly more than these older non-hormone options.

The menopause society does not recommend supplements, herbal remedies, soy foods or extracts, cooling techniques, avoiding triggers, yoga or exercise for hot flashes. Keep moving because it is good for you, but don't expect your spin class to stop the night sweats.

The society does list weight loss as an option for hot flashes, though with more limited evidence. If losing weight is already on your list, our clinical team can talk through semaglutide or tirzepatide and whether one fits your goal.

Are hormones better than non-hormonal options?

Yes. Hormone therapy is still the most effective treatment for hot flashes. The menopause society says it should be considered for women within 10 years of their last period.

Non-hormonal pills are for women who aren't good candidates for hormones, for example after an estrogen-dependent cancer or with heart disease. They are also for women who would rather not take hormones.

If you have been avoiding hormones out of worry rather than for a medical reason, they deserve a second look. Hot or Nothing's hormone plans include bioidentical estrogen, and your clinical team decides whether it suits your history.

Take the quiz to tell our clinical team about your hot flashes, your sleep and whether hormones are on the table for you, and see which plan fits your goal.