What is the most effective treatment for vasomotor symptoms associated with menopause in patients without contraindications?

The most effective treatment for vasomotor symptoms associated with menopause, such as hot flashes and night sweats, is low-dose estrogen therapy, especially for patients who do not have any contraindications. Estrogen works directly to alleviate these symptoms by stabilizing the hormonal fluctuations that lead to such vasomotor disturbances.

In women experiencing menopausal symptoms, the decline in estrogen levels is a primary factor contributing to an increase in these symptoms. By supplementing with low-dose estrogen therapy, these women can experience significant relief from their discomfort, making it a highly effective approach.

While there are other options available for treating vasomotor symptoms, such as SSRIs and gabapentin, these treatments are generally considered secondary and may not be as effective as estrogen. SSRIs might be used to help manage mood swings and depression associated with menopause, but they do not target the physiological mechanisms behind vasomotor symptoms as directly as estrogen does. Gabapentin is another alternative that has been shown to reduce hot flashes in some cases, but it is often less effective compared to hormone replacement therapy. Oral paroxetine, an SSRI, has also been approved for this use, but again, it does not match the efficacy of low-dose estrogen therapy in directly treating the core