Name one nonhormonal pharmacologic therapy for VMS.

• A. Vaginal estrogen
• B. SSRIs (e.g., paroxetine)
• C. NSAIDs
• D. Exercise

Answer: (B)

When addressing vasomotor symptoms with nonhormonal pharmacologic therapy, a class of drugs that can help is the selective serotonin reuptake inhibitors (SSRIs). These medications work by increasing serotonin levels in the brain, which can stabilize the hypothalamic thermoregulatory center and reduce the frequency and intensity of hot flashes. Paroxetine, used at a low dose, is a prime example and has approval for vasomotor symptoms, making it a solid choice when hormonal therapy isn’t suitable or desired.

Vaginal estrogen is hormonal therapy, not nonhormonal. NSAIDs are not effective for vasomotor symptoms, and exercise is a nonpharmacologic approach rather than a drug therapy. So among pharmacologic options that don’t involve hormones, an SSRI like paroxetine best fits the goal.