So the mainstay of treatment for menopause, treating hot flashes and night sweats associated with menopause is hormones, typically an estrogen. And some women need a progestin based on if they have a uterus or not.

But for some women, they either choose not to use hormones or they can't use hormones because they have, for example, breast cancer or a blood clot. So in that case, we would choose a medication that's not a hormone, such as many of the non hormonal medications or other treatments that we have available. There are a lot of over-the-counter supplements that have been looked at to help symptoms of menopause. But when we do study them, we don't see that there are any more beneficial than placebo.

But there are some therapies that are not medication, such as cognitive behavioral therapy or even clinical hypnosis that has been studied and found to be effective at treating hot flashes and night sweats. So if women don't want to take hormones, they could consider one of the non hormonal medications. There's only one that's FDA approved for hot flashes and night sweats, it's called paroxetine, but it's in a class of medications called the SSRIs, also called antidepressants. But in this case we would be using it for treatment of menopausal symptoms and not necessarily for depression. There's also other medications like gabapentin, oxybutynin. All of those would be used off-label, but have data to support that they will treat the symptoms of menopause.

If women experience menopause, meaning they stopped menstruating for 12 months, younger than the age of 40, that's considered early menopause. And those women need to talk to their doctors about hormone replacement therapy. Because that's a different subset of women than those that are experiencing symptoms during the typical period of menopause. We find that women that go through early menopause that are on hormones have higher risks of things like heart disease, dementia. If they're not on hormone therapy until the average age of menopause, which is again 51 years of age.

So I want women to know that hormones are not bad. And if they don't have significant risk factors or other medical issues, that they could consider using hormones. And then I guess in that vein that if they can't use hormones or they choose not to, that we have other options to help treat them.