Hot-flash relief without hormones.
Some women can't take estrogen, including many breast-cancer survivors. Others would simply rather not. Either way, there are now effective medicines made just for hot flashes, and older ones with years of evidence behind them.
- Same clinicians whenever possible
- Bridgewater, Nutley & telehealth statewide
- Nearly every major plan, including Medicaid
The newest option: medicines made for hot flashes
Falling estrogen overexcites a small group of nerve cells in the brain's temperature control center. That is what sets off a hot flash. Two newer medicines calm those signals directly, without adding any hormone.
Veozah (fezolinetant)
Approved in 2023 and taken once a day. It reduces how often hot flashes happen and how strong they are, often within the first week. Most women tolerate it well. Because it can rarely affect the liver, we check routine liver blood tests during the first months of treatment, as the label recommends.
Lynkuet (elinzanetant)
FDA-approved in October 2025 and taken once at bedtime. It works on two receptors in the same brain pathway instead of one. In the approval studies it cut hot flashes substantially and improved sleep. The most common side effects are sleepiness, headache and dizziness, which is part of why it's taken at night.
Both are brand-name medicines. Coverage varies by plan, and some insurers want a generic tried first. We don't stop at the first denial. Our team works through prior authorizations and appeals, as many as it takes, to get you the medicine that's right for you.
Proven options with a longer track record
These medicines were developed for other conditions but have good evidence for hot flashes. Most are generic and inexpensive.
Low-dose antidepressants
Paroxetine at a low dose is FDA-approved for hot flashes. Venlafaxine, escitalopram and others are also used. A good choice when anxiety, low mood or irritability come along with the hot flashes.
Gabapentin
Taken at bedtime, it reduces night sweats and can improve sleep. Daytime drowsiness and dizziness are the main side effects, which usually fade.
Oxybutynin
A bladder medicine that also reduces hot flashes. It can be a good fit if you also have urgency or leaking, though it isn't usually used in older women because of its effects on memory.
Treatments without medicine
Two approaches have strong evidence and no side effects. The Menopause Society recommends both.
- Cognitive behavioral therapy (CBT): doesn't make hot flashes less frequent, but makes them much less bothersome and improves sleep. We refer you to a therapist who offers it.
- Clinical hypnosis: a structured program that reduces how often hot flashes happen and how intense they feel.
- Weight loss: for women carrying extra weight, losing some can reduce hot flashes. Weight management
Acupuncture is a different case. Some women find it helps, and studies comparing it with no treatment have shown benefit, but studies comparing it with sham acupuncture are mixed. The Menopause Society doesn't recommend it on its own for hot flashes. We offer medical acupuncture as an add-on, especially when sleep and anxiety are part of the picture. Integrative menopause care
Things that sound helpful but aren't
Paced breathing, cooling pillows, most herbal supplements and "hormone-balancing" diets haven't held up in good studies. Black cohosh has mixed results and rare reports of liver injury. We'll tell you what the evidence shows before you spend money on it.
No estrogen doesn't mean no relief.
Most new patients are seen within a week, in person in Bridgewater or Nutley, or by video anywhere in New Jersey.
After breast cancer
Hot flashes after breast cancer can be especially severe, because some cancer treatments bring on menopause suddenly or block estrogen on purpose. Non-hormonal options are usually the first choice.
Some antidepressants, including paroxetine and fluoxetine, interfere with how tamoxifen works, so we choose among the others instead. We coordinate with your oncologist on every decision and keep them updated.
Low sex drive
Many women notice their interest in sex fading around menopause. When that loss of desire is distressing and nothing else explains it, Addyi (flibanserin) is a non-hormonal option: a pill taken once a day at bedtime. It has been FDA-approved for women before menopause since 2015, and since December 2025 for postmenopausal women under 65.
First we look for anything that can dampen desire, such as vaginal dryness or pain, poor sleep, low mood, thyroid problems or a medication. Addyi works gradually, so we judge it after about eight weeks and stop it if it hasn't helped. Alcohol takes some planning: wait at least two hours after one or two drinks before taking it, and skip that night's dose after three or more. We check it against your other medicines, too.
Choosing the right option for you
- Mostly night sweats and poor sleep? Gabapentin or Lynkuet at bedtime, plus CBT for insomnia.
- Anxiety or low mood too? A low-dose antidepressant can treat both.
- Hot flashes all day, nothing else? Veozah or Lynkuet are designed for exactly this.
- Bladder urgency as well? Oxybutynin may cover both.
- Low sex drive that bothers you? Addyi may help once other causes are ruled out.
We check every option against your other medicines and conditions. That's easy for us, because we're also your primary-care practice.
What to expect
Your first visit covers your symptoms, health history and medicines, in person or by video. Most women start one option and check in after four to six weeks with the same clinician. If it isn't working well enough, we adjust the dose or try another.
Why women choose PremierMD
- The same clinicians whenever possible. Kayla Yanga, NP, leads our clinic in Nutley, and Jackie Bruno, NP, sees patients in Bridgewater.
- Every option under one roof. Hormone therapy if that becomes right for you, non-hormonal medicines, counseling, acupuncture and primary care.
- We fight for your coverage. Nearly every major plan is accepted, including Medicaid, and when an insurer pushes back on a medicine like Veozah, we keep going through prior authorizations and appeals.
More from our clinic
Perimenopause & Menopause Clinic
An overview of everything we treat, plus a six-question symptom check.
Learn moreHormone Therapy
Patches, gels and pills explained, and what changed about safety in 2025.
Learn moreHot Flashes: Natural Remedies
What helps without prescriptions, from our health library.
Read the guideNon-hormonal treatment questions
What is the best non-hormonal treatment for hot flashes?
It depends on your health and your other symptoms. Veozah and Lynkuet were designed specifically for hot flashes and work well for many women. Low-dose antidepressants are a good choice if mood or anxiety is also a problem, and gabapentin at bedtime helps when night sweats are the main issue.
What is the difference between Veozah and Lynkuet?
Both block signals in the brain's temperature control center. Veozah (fezolinetant) was approved in 2023 and is taken once a day. It needs routine liver blood tests during the first months. Lynkuet (elinzanetant) was approved in October 2025, is taken at bedtime, and acts on two receptors instead of one. We choose between them based on your health, side effects and insurance coverage.
Can I take these medicines if I've had breast cancer?
Often, yes. Non-hormonal options are commonly used by breast-cancer survivors. Some antidepressants interact with tamoxifen, so we choose carefully and coordinate with your oncologist.
How quickly do non-hormonal treatments work?
Veozah and Lynkuet often reduce hot flashes within the first week or two. Antidepressants and gabapentin usually take two to four weeks to reach their full effect.
Does insurance cover Veozah or Lynkuet?
Many plans cover them, sometimes after prior authorization or trying a generic option first. We accept nearly every major insurance plan, including Medicaid, and we don't stop at the first denial: our team handles prior authorizations and appeals for you. Generic options such as paroxetine, venlafaxine and gabapentin are covered by nearly every plan.
Does acupuncture help hot flashes?
Some women find acupuncture helps, and studies comparing it with no treatment have shown benefit. Studies comparing it with sham acupuncture are mixed, and the Menopause Society does not recommend it as a hot-flash treatment on its own. We offer it alongside proven treatments, especially when sleep and anxiety are part of the picture.
Can I combine non-hormonal treatments?
Sometimes. For example, a medicine for hot flashes plus CBT for sleep often works better than either alone. We check every combination for interactions, including with any supplements you take.
Is there a non-hormonal treatment for low sex drive after menopause?
Yes. Addyi (flibanserin), a pill taken once a day at bedtime, was approved in December 2025 for postmenopausal women under 65 with distressing low sexual desire. It was already approved for women before menopause. We first look for other causes, such as vaginal dryness, poor sleep, low mood or a medication, and we judge whether it's working after about eight weeks. Because it can lower blood pressure, alcohol needs to be timed carefully around the dose.
- The 2023 Nonhormone Therapy Position Statement of The North American Menopause Society. Menopause 2023;30(6):573–590.
- Bayer. Lynkuet (elinzanetant) approved in the U.S. for moderate to severe vasomotor symptoms due to menopause. October 24, 2025.
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