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ACP puts hormone therapy first for menopause symptoms

Estrogen-based therapy is now recommended first for vasomotor symptoms, with SNRIs, SSRIs, gabapentin, and neurokinin receptor antagonists reserved for later lines.

  • By

  • Teraya Smith

  • October 6, 2026

  • 4 min

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  • 1

    The American College of Physicians recommends hormone therapy as the first-line treatment for menopausal vasomotor symptoms.

  • 2

    Estrogen combined with a progestogen is recommended for patients with a uterus, while estrogen monotherapy is for those without.

  • 3

    For patients intolerant to first-line therapy, the ACP conditionally recommends desvenlafaxine or venlafaxine as second-line treatments.

  • 4

    The ACP advises using the lowest effective dose of estrogen and cautions about potential risks associated with hormone therapy.

  • 5

    Most studies informing the guidelines involved generally healthy postmenopausal patients, limiting broader application of the recommendations.

Original Source(s)

ACP puts hormone therapy first for menopause symptoms

  • by Teraya Smith

  • October 6, 2026

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