New Guidelines Favor Hormone Therapy for Hot Flashes

New guidance issued by the American College of Obstetricians and Gynecologists (ACOG) strongly endorses hormone therapy as a primary treatment for menopausal symptoms, including hot flashes, night sweats, and sleep disturbances. This marks a shift from previous recommendations that emphasized the shortest effective duration.

The updated guidelines, released on October 15, 2026, advocate for a more personalized approach, encouraging regular review of treatment choices and emphasizing flexibility. The goal is to empower individual decision-making rather than adhering to rigid rules regarding treatment length or intensity.

While hormone therapy is typically best initiated before age 60 or within 10 years of menopause, ACOG acknowledges that patients already undergoing treatment may need to continue beyond age 60 to effectively manage persistent symptoms. Exceptions to hormone therapy include women with contraindications such as a history of blood clots, stroke, or certain cancers.

For women where hormone therapy is not suitable, ACOG now recommends a broader spectrum of alternative treatments than previously advised. These new guidelines align with similar recommendations published recently by the American College of Physicians.