Non-Hormonal Breakthroughs — The "Dual-Track" Era
For women who are contraindicated for hormones—such as those with a history of breast cancer—2026 has introduced highly effective Non-Hormonal Pharmacotherapy.
Neurokinin Antagonists: Drugs like Fezolinetant target the thermoregulatory center in the hypothalamus. This allows patients to "switch off" vasomotor symptoms like hot flashes and night sweats without introducing systemic estrogen.
SSRIs and SNRIs: Low-dose paroxetine and venlafaxine are used to manage both mood instability and moderate hot flashes, providing a psychological and physiological safety net.
Cognitive Behavioral Therapy (CBT): 2026 guidelines formally recognize telephone-based CBT as a validated treatment for menopause-related insomnia, often performing as well as hormonal interventions for sleep quality.