Which of the following is an example of a nonhormonal pharmacologic therapy for VMS?

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

Answer: (C)

Nonhormonal pharmacologic therapy for vasomotor symptoms works by altering brain signaling rather than by supplying hormones. Serotonin reuptake inhibitors, used at low doses, help stabilize the hypothalamic center that controls body temperature, reducing the frequency and intensity of hot flashes. Paroxetine is a classic example of an SSRI that has proven benefit for vasomotor symptoms, making it the best choice among the options when a nonhormonal drug approach is needed.

Vaginal estrogen provides estrogen and is considered hormonal therapy, so it’s not the nonhormonal option. NSAIDs don’t have a meaningful impact on vasomotor symptoms. Exercise can improve overall well-being and sleep, but it isn’t a pharmacologic therapy.