Strong (A)
Systemic hormone therapy
70-90% drop in frequency & severity
Requires clinician review; not suitable for some conditions
Strong (A)
Low-dose SSRI/SNRI (e.g., paroxetine 7.5 mg)
25-55% fewer flashes in 1-2 weeks
Possible nausea/insomnia; drug interactions
Strong (A)
NK3-receptor blocker (fezolinetant)
Significant relief when hormones aren't an option
Liver-function checks; coverage varies
Moderate (B)
Low-fat, plant-forward diet + modest weight loss
Up to 78-88% reduction after 12 weeks
Works best with 3-4 kg weight loss & soy/legume focus
Moderate (B)
Structured resistance training or yoga
20-40% flash drop; boosts mood & bone
Need 2-3 sessions/week; evidence emerging
Emerging (C+)
Paced breathing / CBT
≈30% fewer daily flashes; helps sleep & stress
Requires practice or guided sessions