title: EMAS position statement: Non-hormonal management of menopausal vasomotor symptoms.
abstract: OBJECTIVE
  To review non-hormonal therapy options for menopausal vasomotor symptoms. The current EMAS position paper aims to provide to provide guidance for managing peri- and postmenopausal women who cannot or do not wish to take menopausal hormone therapy (MHT).
  
  
  METHODS
  Literature review and consensus of expert opinion.
  
  
  RESULTS
  Non-hormonal management of menopausal symptoms includes lifestyle modifications, diet and food supplements, non-hormonal medications and application of behavioral and alternative medicine therapies. There is insufficient or conflicting evidence to suggest that exercise, supplements or a diet rich in phytoestrogens are effective for vasomotor menopausal symptoms. Selective serotonin-reuptake inhibitors (SSRIs), serotonin norepinephrine-reuptake inhibitors (SNRIs) and gabapentin could be proposed as alternatives to MHT for menopausal symptoms, mainly hot flushes. Behavioral therapies and alternative medicine interventions have been tried, but the available evidence is still limited.
  
  
  CONCLUSIONS
  A number of interventions for non-hormonal management of menopausal vasomotor symptoms are now available. For women who cannot or do not wish to take estrogens, non-hormonal management is now a realistic option.
authors.affiliation: Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece.
authors.forename: Gesthimani
authors.initials: G
authors.lastname: Mintziori
authors.affiliation: Second Department of Obstetrics and Gynecology, Medical School, National and Capodestrian University of Athens, Greece.
authors.forename: Irene
authors.initials: I
authors.lastname: Lambrinoudaki
authors.affiliation: Unit of Reproductive Endocrinology, First Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, Greece. Electronic address: dimitrios.goulis@otenet.gr.
authors.forename: Dimitrios G
authors.initials: DG
authors.lastname: Goulis
authors.affiliation: Department of Obstetrics and Gynecology, 'Carol Davila' University of Medicine and Pharmacy, and Department of Obstetrics and Gynecology, 'Dr. I. Cantacuzino' Hospital, Bucharest, Romania.
authors.forename: Iuliana
authors.initials: I
authors.lastname: Ceausu
authors.affiliation: Breast Clinic and Menopause Clinic, University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
authors.forename: Herman
authors.initials: H
authors.lastname: Depypere
authors.affiliation: Department of Obstetrics and Gynecology, Istanbul University, Cerrahpasa School of Medicine, Valikonagi Cad. No: 93/4, Nisantasi, 34365 Istanbul, Turkey.
authors.forename: C Tamer
authors.initials: CT
authors.lastname: Erel
authors.affiliation: Department of Obstetrics and Gynecology, Zaragoza University Facultad de Medicina, Hospital Clínico, Zaragoza 50009, Spain.
authors.forename: Faustino R
authors.initials: FR
authors.lastname: Pérez-López
authors.affiliation: Department of Medicine, Cardiology Unit and Head Centre for Gender Medicine, Karolinska Institutet and Karolinska University Hospital, Thorax N3:06, SE 17176 Stockholm, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Schenck-Gustafsson
authors.affiliation: Department of Clinical and Experimental Medicine, University of Pisa, Via Roma, 67, 56100 Pisa, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Simoncini
authors.affiliation: Menopause and Metabolic Bone Disease Unit, Hôpital Paule de Viguier, F-31059 Toulouse cedex 09, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Tremollieres
authors.affiliation: Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Rees
mesh_terms: D000588:Amines / Q000627:therapeutic use; D001521:Behavior Therapy; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D000529:Complementary Therapies; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D004032:Diet; D015444:Exercise; D005260:Female; D000077206:Gabapentin; D019584:Hot Flashes / Q000628:therapy*; D006801:Humans; D008019:Life Style; D008593:Menopause / Q000187:drug effects / Q000502:physiology*; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use; D013546:Sweating; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D002121:Calcium Channel Blockers; D003509:Cyclohexanecarboxylic Acids; D000077206:Gabapentin; D017367:Selective Serotonin Reuptake Inhibitors; D005680:gamma-Aminobutyric Acid
keywords: Behavioral therapies; Gabapentin; Menopause; Non-hormonal management; Selective serotonin-reuptake inhibitors; Vasomotor symptoms