Veozah, Lynkuet or HRT?
There are now two medicines made specifically for hot flashes, alongside hormone therapy. Here's how they work, how they compare, and who each one suits.
The short answer: hormone therapy is still the most effective treatment for hot flashes and also helps vaginal dryness and bones. Veozah (fezolinetant) and Lynkuet (elinzanetant) are non-hormonal medicines that calm the brain's temperature control center directly. They're excellent options for women who can't or would rather not take estrogen. Lynkuet is taken at bedtime and also improved sleep in its studies.
How the new medicines work
Deep in the brain, a small group of nerve cells helps set your body temperature. Estrogen normally keeps them in check. When estrogen falls, these cells become overactive and misread your temperature, which triggers the sudden heat, flushing and sweating of a hot flash.
Veozah and Lynkuet block signals to those cells. Hormone therapy works differently, by replacing some of the estrogen. The result for hot flashes is similar, but hormone therapy also acts on the rest of the body, while the new medicines target hot flashes specifically.
Side by side
Hormone therapy
How: replaces estrogen, with progesterone if you have a uterus.
Treats: hot flashes, night sweats, sleep, vaginal dryness, and helps prevent bone loss.
Best for: most healthy women under 60 or within 10 years of menopause.
Not for: women with a history of breast cancer, clots or stroke.
Veozah
How: blocks the NK3 receptor. One tablet daily, approved in 2023.
Treats: hot flashes and night sweats.
Best for: women who can't or would rather not take estrogen.
Note: most women tolerate it well. Routine liver blood tests during the first months, as the label recommends.
Lynkuet
How: blocks both NK1 and NK3 receptors. Taken at bedtime, approved October 2025.
Treats: hot flashes and night sweats, and improved sleep in studies.
Best for: women whose night sweats wreck their sleep.
Note: common side effects include sleepiness, headache and dizziness.
The best choice is the one that fits your history.
Most new patients are seen within a week, in person in Bridgewater or Nutley, or by video anywhere in New Jersey.
How we help you choose
- Hot flashes plus vaginal dryness or bone concerns? Hormone therapy covers the most ground. Hormone therapy
- History of breast cancer, clots or stroke? Non-hormonal options come first. Non-hormonal treatment
- Night sweats ruining sleep? Lynkuet at bedtime, or hormone therapy with bedtime progesterone.
- Anxiety or low mood too? A low-dose antidepressant may treat both at once.
- Worried about cost? Generic hormone therapy and generic non-hormonal options are covered by nearly every plan. Insurance coverage
Older non-hormonal options still work
Before Veozah and Lynkuet, women who couldn't take estrogen relied on low-dose paroxetine, which is FDA-approved for hot flashes, and on other antidepressants such as venlafaxine and escitalopram, plus gabapentin at bedtime and oxybutynin. They remain good, inexpensive choices, particularly when another symptom, such as anxiety, poor sleep or bladder urgency, can be treated at the same time.
Keep reading
Veozah, Lynkuet and HRT questions
Is Veozah better than HRT?
Not in general. Hormone therapy is still the most effective treatment for hot flashes, and it also helps vaginal dryness and bone health. Veozah is an excellent option for women who can't or would rather not take estrogen.
What's the difference between Veozah and Lynkuet?
Both calm the brain's temperature control center without hormones. Veozah (fezolinetant) blocks one receptor, is taken once a day, and needs routine liver blood tests during the first months. Lynkuet (elinzanetant) blocks two receptors, is taken at bedtime, and in its studies also improved sleep. Drowsiness is one of its common side effects.
Do Veozah and Lynkuet help with anything besides hot flashes?
They're designed for hot flashes and night sweats. Lynkuet also improved sleep in its studies. Neither treats vaginal dryness or protects bones the way estrogen does.
Can I take Veozah or Lynkuet after breast cancer?
They're non-hormonal, which makes them attractive after breast cancer, but whether they're right for you depends on your treatment and other medicines. We decide together with your oncologist.
How fast do they work?
Many women notice fewer hot flashes within the first week or two on Veozah or Lynkuet. Hormone therapy usually works within two to four weeks.
Are they covered by insurance?
Veozah and Lynkuet are brand-name, and many plans cover them after prior authorization or trying a generic option first. We handle the prior authorizations and, when needed, the appeals. Generic estradiol and progesterone are covered by most plans at a low copay.
- Bayer. Lynkuet (elinzanetant) approved in the U.S. for moderate to severe vasomotor symptoms due to menopause. October 24, 2025.
- The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society. Menopause 2023;30(6):573–590.
- The 2022 Hormone Therapy Position Statement of The North American Menopause Society. Menopause 2022;29(7):767–794.
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