• To help reduce hot flushes, women should be encouraged to take regular exercise, reduce stress and wear lighter clothing. Any trigger factors should be avoided.

• Clonidine is the only non-oestrogen based preparation that is licensed for menopausal flushing, but its use is limited by moderate efficacy and relatively high rate of adverse effects.

• Studies have also been conducted using gabapentin, methyldopa, octreotide, and pregabalin which have produced variable results.

• One small meta-analysis has suggested that gabapentin at a dose of 300mg three times daily may be effective, but the adverse effect profile may restrict its use.

 
• Most of these studies have been short-term, and the long-term efficacy of non-hormonal treatment for hot flushes is not known. As data are limited, it has been suggested that their use should be restricted to highly symptomatic women who cannot take oestrogen.

 
• Clinicians should continuously review efficacy of treatment and assess whether an alternative treatment is necessary.