Hot flashes without hormones guide

Hot flashes without hormones online

For adults 45 to 64 with hot flashes or night sweats that bother their sleep or day, who have had no period for 12 months or more, or had both ovaries removed, and who cannot take or do not want hormone therapy.

Start online

Start a $59 online review for Hot flashes without hormones.

Hot flashes and night sweats are common after menopause. Some people cannot take hormone therapy, or do not want to. A low-dose pill called paroxetine 7.5 mg (Brisdelle) is approved by the FDA to treat moderate to severe hot flashes from menopause. It has no hormones. You take one at bedtime, and you check in with your doctor before each refill. Talk therapy (CBT) and hypnosis can also help. If you want hormone therapy, use our menopause hormone therapy visit.

If treatment is appropriate, your physician can send a non-controlled prescription to your pharmacy and provide portal instructions for the next step.

Start this visit See response times

Already in ongoing care with us for this? Check-ins are $39 (your first one is free).

Quick facts

You must be physically located in Virginia or West Virginia at the time of request.
Starts at $59
No insurance needed
No app download
Physician review around the clock
Non-controlled prescriptions can be sent to your pharmacy when appropriate
A work or school note can be included when medically appropriate
Response times apply 24/7, every day

Common symptoms

Hot flashes or night sweats that wake you up or get in the way of your day
No period for 12 months or more, or both ovaries removed
You had breast cancer, a blood clot, or a stroke, so hormones may not suit you
You simply prefer a treatment without hormones

May fit online care

Adults 18 and older
You are 45 to 64
Your hot flashes or night sweats bother your sleep or your day
You have had no bleeding after your periods stopped
You agree to check in at 2 weeks, then each month before each refill

Look for another care setting

Thoughts that you would be better off dead, or of hurting yourself in any way (call or text 988, or call 911).
Still having periods, or possible pregnancy.
Under 45, or 65 or older.
Any bleeding after menopause (needs an in-person exam now).
Feeling down or anxious on many days now (see your own doctor, or use our anxiety and depression visit if you are under 65).
Narrow-angle glaucoma, or narrow angles in the eyes, that have not been treated.
Tamoxifen, or cancer treatment now.
Mania, hypomania, bipolar disorder, or psychosis, or lithium or another mood stabilizer.
An allergy to paroxetine or anything in the capsule, or past serotonin syndrome or neuroleptic malignant syndrome.
A past stay in a hospital for your mental health, a past suicide attempt, or past serious thoughts of ending your life.
A medicine for depression, anxiety, or mood now, including buspirone.
An MAOI, linezolid, methylene blue, thioridazine, or pimozide.
A blood thinner.
Heavy drinking or drug use.
Digoxin, theophylline, risperidone, atomoxetine, flecainide, propafenone, or a tricyclic medicine.

What to have ready

When your last period was, or when your ovaries were removed
How often your hot flashes come, and what you have tried
Every medicine, vitamin, and supplement you take, with the dose
Any past depression or anxiety, and any family history of it

What happens next

Standard

$59

Within 6 hours

Priority

$99

Within 3 hours

Rush

$149

Within 1 hour

Start the request on the website, answer a few questions to check that this visit fits you, and choose how fast you want an answer (the response window). If your concern still fits this service, a physician reviews it and sends you a secure update after you sign in. When appropriate, non-controlled prescriptions can be sent to your pharmacy, and a basic work or school note can be included at physician discretion.

Your physician

Every visit is personally reviewed by Ankur Fadia, MD. He is board-certified, has extra training in heart care (a cardiology fellowship), and is a member of Alpha Omega Alpha, a medical honor society. He is licensed in Virginia and West Virginia, and your care is never handed off to someone else.

About Ankur Fadia, MD Verify Virginia medical license Verify West Virginia medical license Verify board certification

How does the pill help with hot flashes?

Paroxetine 7.5 mg is a low dose of a medicine from the SSRI group. The FDA approved it to treat moderate to severe hot flashes from menopause. You take one capsule at bedtime. Many people notice fewer hot flashes within a few weeks. If it does not help after about 12 weeks, your doctor will talk with you about other choices.

Why are there check-ins?

Medicines in this group can cause mood changes in some people, so your doctor checks your mood, your side effects, and your hot flashes. Your first check-in is at 2 weeks, and it is free. After that, you check in each month before each 30-day refill. There are no refills without a check-in.

What should I watch for while I take it?

Call or text 988, or call 911, right away if you have thoughts of hurting yourself. Stop the pill and go to the ER for a high fever, stiff or twitching muscles, or new confusion or agitation. Also stop the pill and go to the ER for a fast heartbeat, heavy sweating, or shaking. This applies if it is not like your usual hot flashes, or does not pass in a few minutes. Do not stop the pill all at once without asking your doctor.

Other conditions we treat

Not quite what you have? Here are other conditions we treat.

Birth control Bacterial vaginosis Combined birth control Delay your period Morning-after pill Heavy menstrual bleeding