The 2023 nonhormone therapy position statement of The North American Menopause Society.
Level 5 - mechanism / opinion, no new human data
Expert consensus position statement and narrative literature review by an advisory panel
PubMed 37252752 · doi:10.1097/GME.0000000000002200
What was done
An advisory panel of clinicians and research experts in women's health updated the 2015 North American Menopause Society (NAMS) position statement by reviewing post-2015 literature on nonhormonal management of menopause-associated vasomotor symptoms. Interventions were categorized into five domains: lifestyle; mind-body techniques; prescription therapies; dietary supplements; and acupuncture, other treatments, and technologies. The panel graded the evidence and formulated recommendations as Level I (good and consistent scientific evidence), Level II (limited or inconsistent scientific evidence), or Level III (consensus and expert opinion).
What was found
The abstract reports no numerical effect sizes, counts of included studies, or patient numbers. The panel recommended: cognitive-behavioral therapy, clinical hypnosis, SSRIs/SNRIs, gabapentin, and fezolinetant (Level I); oxybutynin (Levels I-II); and weight loss along with stellate ganglion block (Levels II-III). Interventions classified as not recommended included paced respiration (Level I); dietary supplements and herbal remedies (Levels I-II); cooling techniques, trigger avoidance, exercise, yoga, mindfulness-based interventions, relaxation, suvorexant, soy foods and soy extracts, soy metabolite equol, cannabinoids, acupuncture, and calibration of neural oscillations (Level II); chiropractic interventions and clonidine (Levels I-III); and dietary modification and pregabalin (Level III).
Why it matters
This position statement provides updated clinical guidance on evidence-supported nonhormonal treatments for vasomotor symptoms in menopausal women who have contraindications to hormone therapy or prefer nonhormonal options.
Limits
The abstract does not provide systematic review methodology, search terms, screening flow, total sample size, or quantitative effect estimates. As a consensus statement and review, recommendations represent panel synthesis rather than a single direct trial.
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