In 2025, menopause care has entered a new era, with groundbreaking drugs, refined hormone guidelines, and science-backed mind–body therapies transforming how women find relief.
October’s World Menopause Month is the perfect time to look at how far menopause care has come, and the progress is striking. Today’s women have access to more precise, evidence-based treatments than ever before. From new nonhormonal medications to updated professional guidelines and fresh insights into mind–body therapies, menopause care in 2025 looks nothing like it did even a decade ago.
Hot Flashes: A New Class of Nonhormonal Treatment
For years, women who could not take estrogen were given antidepressants, gabapentin, or clonidine to reduce hot flashes. These medications offered partial relief but were never designed specifically for menopause symptoms. That has now changed.
The newest class of medication—neurokinin receptor antagonists—targets the brain pathways that trigger hot flashes. Fezolinetant, approved by the FDA, is one such medication. Studies show that many women notice a difference within days, with a dramatic reduction in both the frequency and severity of hot flashes. Research continues to confirm its effectiveness over the long term.
Another medication in the same class, elinzanetant, is expected to become available soon. Data from 2025 show strong results through one year of use, with added benefits for sleep. Approval in more countries is underway, and it is currently under review by the FDA.
If estrogen is not an option, these medications are worth discussing with a healthcare provider. Even women on breast cancer treatments, who are often unable to take hormones, may be eligible for trials using fezolinetant, signaling a new chapter for symptom relief.
Hormone Therapy: Clearer Guidance and Greater Confidence
Hormone therapy remains the most effective treatment for hot flashes and night sweats when started before age 60 or within ten years of the final period. New position statements emphasize personalized care and informed choice rather than blanket recommendations.
The key message is that for healthy women in early menopause, the benefits of hormone therapy often outweigh the risks. The latest guidelines stress individualized dosing, ongoing monitoring, and the importance of reviewing therapy every few years.
As for so-called “bioidentical” hormones and pellets, experts caution that not all are created equal.FDA-approved estradiol and progesterone products are bioidentical and regulated for safety and consistency. Custom-compounded blends and hormone pellets, however, are not FDA-approved, and their potency and purity can vary widely. The safest approach is to choose regulated products that have undergone rigorous testing.
Sleep, Mood, and Cognitive Support
Menopause can disrupt sleep and mood as much as it affects body temperature. Fortunately, nonhormonal treatments are evolving here too. Cognitive Behavioral Therapy (CBT) and clinical hypnosis now have strong scientific backing as first-line tools for improving sleep and reducing the distress caused by hot flashes.
These therapies teach skills that help reframe how the body and mind respond to hot flashes and insomnia. Studies show they can work well alone or in combination with medications. As researchers deepen their understanding of how the brain regulates temperature and stress, expect even more refined approaches to emerge.
Genitourinary Syndrome of Menopause: New Guidelines
Vaginal dryness, burning, painful intercourse, urinary urgency, and recurrent infections are part of what is now called Genitourinary Syndrome of Menopause (GSM). In 2025, a new U.S. clinical guideline was released to help healthcare providers treat these symptoms more effectively.
The strongest recommendation is for low-dose vaginal estrogen, which is considered first-line therapy for most women. It can relieve dryness, reduce infections, and improve comfort with minimal systemic absorption. For those who prefer non-estrogen options, vaginal DHEA and the oral medication ospemifene are also effective.
Lubricants and moisturizers remain useful, especially when combined with hormonal treatments. The new guidelines emphasize that GSM does not go away on its own; long-term maintenance is key to ongoing comfort and urinary health.
As for vaginal lasers, the data are mixed. High-quality trials have not shown them to outperform standard therapies, and most professional societies advise against their routine use until stronger evidence exists.
Stellate Ganglion Block: A Procedural Option
For women whose hot flashes do not respond to medication, a simple outpatient procedure called a stellate ganglion block is gaining attention. It involves a brief injection near the neck’s sympathetic nerve bundle, which can reduce hot flash frequency and improve sleep in some women. The procedure is quick, has few side effects, and may be particularly useful for women who cannot take hormones, such as breast cancer survivors. While not yet mainstream, it represents a new frontier in nonhormonal care.
Restoring Sexual Desire
When low sexual desire becomes persistent and distressing, treatment can help. The most evidence-based approach involves low-dose testosterone therapy prescribed off-label for postmenopausal women with hypoactive sexual desire disorder. The goal is to restore testosterone to normal female levels, not to the higher levels seen in men.
Experts advise avoiding compounded or over-the-counter hormone creams and sticking with regulated formulations. When used correctly and monitored by a healthcare professional, testosterone therapy can improve sexual satisfaction and overall well-being for the right candidates.
The Menopause Treatment Landscape in 2025
Start with your goals. If hot flashes are your biggest concern and you are healthy and under 60, hormone therapy remains the gold standard. If hormones are not an option, neurokinin receptor antagonists like fezolinetant are now the best nonhormonal choice.
Combine approaches. Mind–body therapies like CBT and hypnosis can reduce the distress of hot flashes and improve sleep quality. They complement both hormonal and nonhormonal treatments.
Treat vaginal and urinary symptoms directly. Use vaginal estrogen, DHEA, or ospemifene for dryness or pain. Do not wait for symptoms to improve on their own; they rarely do.
Be cautious with trendy treatments. Avoid unregulated compounded hormones or laser treatments without solid evidence. Ask for published studies before committing to expensive therapies.
Check in regularly. Revisit your treatment plan every year or two. New medications and studies are emerging rapidly, and what worked two years ago might not be the best fit today.
The Takeaway
Menopause care is becoming more sophisticated, safer, and more personalized. The days of “just deal with it” are over. Women now have real options, from hormone therapy tailored to their needs to cutting-edge nonhormonal drugs, nerve-based treatments, and science-backed mind–body tools.
World Menopause Month is a reminder that menopause is not a medical failure or something to suffer through in silence. It is a life stage that deserves attention and support. The most important step is starting the conversation with your clinician, your friends, or even yourself, about what relief looks like for you.
The progress seen in 2025 shows that menopause treatment is not standing still, and neither should you.
