Which class of drugs is typically recommended for managing hot flashes in menopausal women without a history of breast cancer?

• A. Estrogen therapy
• B. Progestin therapy
• C. Selective serotonin reuptake inhibitors
• D. Androgens

Answer: (A)

Estrogen therapy is the first-line treatment for managing hot flashes in menopausal women who do not have a history of breast cancer. This is primarily because estrogen is effective at directly addressing the hormonal changes that occur during menopause, which are a key contributor to hot flashes.

Estrogen works by stabilizing the temperature regulation center in the hypothalamus, which can become overactive during menopause, leading to the experience of hot flashes. Since hot flashes are associated with reduced estrogen levels, supplementation can significantly help alleviate these symptoms for most women in this demographic.

While other treatment options exist, they are typically considered first when estrogen therapy is contraindicated, such as in women with a history of breast cancer. For example, selective serotonin reuptake inhibitors may also help reduce vasomotor symptoms but are not as effective as estrogen therapy specifically for hot flashes. Progestin therapies are often used in conjunction with estrogen for women who have an intact uterus to prevent endometrial hyperplasia, but they do not address hot flashes directly. Androgens are not standard for treating menopausal symptoms and have limited evidence of benefit in managing hot flashes compared to estrogen.

Thus, estrogen therapy remains the most appropriate and effective option for managing hot flashes in menopausal women without a