Treatments
Hormonal, non-hormonal and non-drug options, graded. Find out what's supported, check Canadian coverage and bring questions to an appointment. We don't prescribe.
This is education, not a recommendation to start, stop or change a medicine. Your doctor or specialist can check what fits your history.
The menu, dose discussion and coverage help are free. Editorial choices aren't sponsored.
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Tonight
Grade CExpert consensus — see the sourceA cooler room and gentle paced breathing can help you feel more comfortable. They aren't proven treatments for reducing hot flashes. For ongoing insomnia, structured CBT-I has stronger evidence.
Find something for tonightThis month
Grade AStrong evidence — see the sourceSSRIs, SNRIs, gabapentin and fezolinetant are guideline-supported options for hot flashes. The choice depends on your medicines, health history and local availability.
Read the prescription optionsWith a doctor
Grade AStrong evidence — see the sourceMenopausal hormone therapy (MHT), often called HRT, is the most effective treatment for moderate-to-severe hot flashes and night sweats. Suitability needs an individual discussion.
Compare MHT optionsMHT dose discussion
The usual principle is the lowest effective dose, reviewed against symptoms, side effects and your health history. A higher dose isn't automatically better. Patches, gels and tablets aren't interchangeable without a prescribing review.
Ask whether a patch, gel or tablet fits your history. If you have a uterus, ask about a progestogen to protect its lining.
Ask what the starting dose is meant to help, what side effects to watch for and when to get help. Your prescriber chooses the dose.
NICE recommends a review at three months, then annually unless there are reasons to review sooner. Ask what would lead to adjusting, switching or staying with the plan.
Guide, not prescription. Check any dose change with your doctor or specialist.
Canada · Coverage help
A drug being listed and your plan paying for it are different questions. Check both with your pharmacist. Coverage rules can change.
Since March 1, 2026, many MHT options are fully covered under Plan NP for eligible MSP-enrolled residents, including those in the wait period. A prescription is still needed. Not every brand or formulation is covered.
Check the official drug listPlan NP eligibility and coverageMHT decision worksheet
Your choices stay on this device. No account needed, and nothing's sent to Nila.
Guide, not prescription. These are starting points for a conversation with your doctor or specialist.
You can also ask whether a blood-pressure check, cholesterol or blood-sugar testing, or a bone-health review is due for you. The right checks depend on your history and previous results, not a standard menopause test panel.
Read SOGC's Menopause Care Continuum →Discussion topics informed by SOGC's clinician-facing tool. Checked October 21, 2026. Hello Nila's wording and worksheet are our own, not a validated decision aid or SOGC endorsement. The parent Menopause Hub reports Government of Canada financial support.
Grade A applies to the linked guidance, not to this worksheet as a validated decision aid. Sources and limitations are below.
Grade A · Testosterone consensus, 2019International consensus informed by randomized trials and systematic review, not one cohort. Testosterone evidence is limited to postmenopausal hypoactive sexual desire disorder after assessment. Supported by the participating professional societies, with no other external funding reported; several contributors disclosed industry relationships.
Starting a new medicine? Keep notes for yourself, or for your next appointment.
Open the free medicine diaryPremature ovarian insufficiency (POI) changes the hormone-replacement discussion, even if symptoms aren't loud. Bone health, diagnosis, fertility and support belong in the plan.
Read the POI guideEvidence checked October 2026.
20 October 2026: FDA label changes, in context. A regulatory update isn't new trial evidence or personal safety clearance.
A guideline brings several studies together, so there's no single participant count. Funding details are shown when verified; missing details aren't assumed to mean independent funding.
Grade A: systemic MHT is the most effective treatment for vasomotor symptoms and prevents bone loss and fractures.
A synthesis, not one trial. Individual benefits and risks depend on age, timing, route and health history.
Read the sourceGrade A: CBT, SSRIs/SNRIs, gabapentin and fezolinetant are supported non-hormonal options for vasomotor symptoms.
Cooling and paced breathing aren't recommended as treatments to reduce vasomotor symptoms. They can still be comfort choices.
Read the sourceGrade A: low-dose vaginal estrogen has the strongest evidence base for genital and urinary symptoms associated with menopause.
GSM means genitourinary syndrome of menopause. After breast cancer, decisions need shared discussion; local treatment isn't the same as systemic MHT.
Read the sourceGrade A: Canadian guidance covers vasomotor symptoms, prescriptions and non-drug approaches.
Guideline synthesis, not a single study. The original guideline is linked; the 2023 nonhormone statement adds newer drug evidence.
Read the sourceGrade A: fezolinetant reduced moderate-to-severe hot-flash frequency and severity compared with placebo in SKYLIGHT 1.
527 participants randomized; 522 received at least one dose
Industry-sponsored by Astellas Pharma (trial registry NCT04003155). A hot-flash trial, not evidence that the drug is suitable for every health history. Ask about current liver safety monitoring.
Read the sourceYour questions belong in the conversation
