Physicians debate hormone therapy versus diet for menopause treatment

The American College of Physicians (ACP) has released new clinical guidelines recommending hormone therapy as the first-line treatment for perimenopausal and postmenopausal females experiencing vasomotor symptoms (VMS), such as hot flashes and night sweats. For patients who cannot tolerate estrogen, the ACP suggests second-line treatments including SNRIs, or third-line options such as SSRIs, gabapentin, or NK receptor antagonists.

In response to these guidelines, the Physicians Committee for Responsible Medicine is calling for the ACP to prioritize dietary changes as a primary treatment. The committee cites research, including the WAVS trial, suggesting that a plant-based diet rich in soy can be as effective as hormone replacement therapy for reducing hot flashes—showing an 88% effectiveness rate compared to the 70-90% range for hormones—without the associated health risks and side effects.