Which medication can be given for menopausal hot flashes when estrogen therapy is contraindicated?

The medication that can be effectively used for menopausal hot flashes when estrogen therapy is contraindicated is oral paroxetine. Paroxetine, a selective serotonin reuptake inhibitor (SSRI), has been specifically studied and shown to alleviate hot flashes in menopausal women. This is particularly important for individuals who cannot undergo estrogen therapy due to contraindications such as a history of certain cancers, thromboembolic disease, or other health concerns.

Oral paroxetine works by modulating serotonin levels in the brain, which can help regulate the body's temperature control mechanisms, thus leading to a reduction in the frequency and severity of hot flashes. The effectiveness of paroxetine in this context has made it a recommended treatment option for managing menopausal symptoms in women who are unsuitable candidates for hormone replacement therapy.

While other medications such as gabapentin and clonidine may also provide symptom relief, they aren’t as specifically indicated for this purpose compared to oral paroxetine. Gabapentin is primarily used for neuropathic pain and may have less consistent effects on hot flashes. Clonidine, a medication typically used for hypertension, may also help with hot flashes but is not as well-established in this role as SSRIs. Therefore, oral paroxetine stands out as the most appropriate option