Hot Flashes Finally Have a Playbook. Here's the Order Doctors Now Agree On.

Posted by
October 16, 2026
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Up to 80% of people who go through menopause get hot flashes and night sweats. For years, the advice on what to do about them has been a mess of mixed messages, half-remembered headlines about hormones, and a lot of "just ride it out."

On October 6, the American College of Physicians published a new guideline that cuts through it. It lays out a clear order of what to try first, second, and third, and it grades how solid the evidence is behind each step. Hormones are back at the front, on the strongest evidence in the whole list.

What the guideline says

The ACP reviewed the research on the common medications for vasomotor symptoms (the clinical name for hot flashes and night sweats) and sorted them into a sequence. What's useful here isn't just the order. It's that they told you how confident the evidence lets them be at each step.

  1. First: hormone therapy. Estrogen with progestogen if you have a uterus, estrogen on its own if you ...

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About the Author

With a background in nursing and a genuine passion for care, Jessie supports myStoria members as part of the Concierge team.

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