Which pharmacologic option is a non-hormonal choice for vasomotor symptoms?

• A. SSRIs or SNRIs.
• B. Gabapentin.
• C. Clonidine.
• D. All of the above.

Answer: (D)

Non-hormonal options for vasomotor symptoms include SSRIs or SNRIs, gabapentin, and clonidine. Each of these works without introducing estrogen, making them useful when hormone therapy isn’t appropriate. SSRIs and SNRIs help by altering central serotonin and norepinephrine signaling, which dampens the hypothalamic set-point shifts that drive hot flashes. Gabapentin reduces neural excitability that may contribute to vasomotor symptoms. Clonidine lowers sympathetic outflow, also helping lessen the frequency and severity of flashes. While the degree of relief can vary among individuals and they may have different side effects, all three categories are valid non-hormonal treatments. Therefore, all the listed options are non-hormonal choices for vasomotor symptoms.