Which of the following is a nonhormonal prescription option for vasomotor symptoms?

• A. Paroxetine
• B. Estradiol
• C. Medroxyprogesterone
• D. Testosterone

Answer: (A)

Nonhormonal strategies for vasomotor symptoms act through mechanisms other than replacing hormones. Paroxetine fits this approach because it’s an SSRI that, at a low dose, is approved to help reduce hot flashes by modulating serotonin pathways that influence thermoregulation. This can lessen how often and how severely hot flashes occur without adding hormones to the body. The other options are hormonal therapies: estradiol is estrogen, medroxyprogesterone is a progestin, and testosterone is an androgen. They address vasomotor symptoms by altering hormone levels, not through nonhormonal mechanisms. So paroxetine is the appropriate nonhormonal prescription option. Side effects and interactions are important to consider, but the core reason it’s the nonhormonal choice is its mechanism as a neurotransmitter-targeting agent rather than a hormone.