Newer non-hormonal medicines for hot flushes: fezolinetant and elinzanetant

For a long time, if HRT was not right for you, the non-hormonal options for hot flushes were medicines borrowed from other uses: certain antidepressants, an epilepsy drug, a blood pressure tablet. They help some women, but none was designed for the job. That has changed. A new class of medicine, developed specifically for menopausal hot flushes, is now available, and it works in a genuinely different way.

This article explains what these medicines are, who they suit, and what they involve.

How they work

Hot flushes are not simply a matter of falling oestrogen. They are driven by a small cluster of nerve cells in the brain that help regulate body temperature. As oestrogen falls, those cells become overactive, and the result is the sudden heat, flushing and sweating of a flush. The new medicines, known as neurokinin receptor antagonists, calm that overactivity directly. They are not hormones, and they do not affect oestrogen levels at all.

Fezolinetant

Fezolinetant, brand name Veoza, blocks one of these receptors, called NK3. It is a tablet taken once a day. In trials it reduced both how often flushes happen and how severe they are, often within a few weeks. It has been recommended for use on the NHS for women with moderate to severe flushes when HRT is unsuitable, and it is available privately as well.

Because the medicine is processed by the liver, a blood test to check liver function is needed before you start and at intervals while you take it. That monitoring is the main practical commitment, and it is the reason this is a treatment a doctor prescribes and follows, rather than something a questionnaire can hand out.

Elinzanetant

Elinzanetant, brand name Lynkuet, is the newer of the two and blocks two receptors rather than one, NK1 as well as NK3. The practical interest in the dual action is that, alongside reducing flushes, it has been shown to help with the sleep disturbance and quality of life that so often come with the menopause. It received its UK approval in 2025 and is currently available on private prescription.

For a woman whose nights are wrecked as much by broken sleep as by the flushes themselves, the sleep benefit can be the deciding factor.

Who these medicines suit

They are worth considering if:

• HRT is not suitable for you, for example because of a history of breast cancer or a blood clot.

• You have chosen not to take HRT but your flushes are still affecting your life.

• You are on HRT and your flushes are only partly controlled.

They are not a replacement for HRT for everyone. HRT remains the most effective treatment for menopausal symptoms overall, and it does other things, such as supporting bone strength, that these medicines do not. But for the specific problem of hot flushes and night sweats in women who cannot or would rather not use hormones, this is the most significant new option in years.

What it involves with us

A GP with specific menopause expertise assesses whether one of these medicines fits your symptoms and your history, arranges the liver function test where it is needed, and reviews how you respond. If we prescribe and dispense for you, the medicine is delivered to your door, and your repeats are checked against your monitoring so nothing lapses. The point of seeing a doctor is precisely the assessment and follow-up that make a newer medicine safe to use well.

Read next

• lifestyle and non hormonal options for menopause

• who should not take hrt

• body identical hrt explained

Ready to start?

If you want to move from reading to acting, the next step is a short assessment with a GP who has specific menopause expertise. It takes about ten minutes and tells you what will help.

Begin your assessment at this link. Online or in person at Westfield London.