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For women unable or unwilling to take HRT , several alternatives exist: Fezolinetant : a neurokinin-3 receptor antagonist specifically licensed for moderate to severe vasomotor symptoms, offering a non-hormonal option [19] [20] Selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs): medications such as venlafaxine, citalopram, or fluoxetine may reduce hot flash frequency, though efficacy varies

The longest completed trial is 68 weeks

Safety Monitoring and Provider-Guided Implementation Combining creatine with GLP-1 medications requires a structured monitoring protocol

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