3 New Perimenopause Treatment Updates Women Should Know

Perimenopause care is changing in important ways.

For many years, women were often told to “deal with” hot flashes, night sweats, mood changes, poor sleep, brain fog, and other midlife symptoms. Today, there are treatment options, better research, and more attention on women’s health.

Three recent developments are helping improve perimenopause and menopause care:

• New non-hormonal medications for hot flashes and night sweats
• Updated hormone therapy guidance and labeling changes
• More government focus on improving access to perimenopause care

At The Gabrielson Clinic for Women, we believe women deserve providers who listen, explain options clearly, and help them make informed choices about their health.

Schedule an Appointment Today

What Is Perimenopause?

Perimenopause is the time before menopause. Menopause is when you have gone 12 months without a period.

Perimenopause often starts in your 40s, but some women notice changes earlier. During this time, hormone levels can rise and fall. These hormone shifts can cause symptoms that come and go.

Common Perimenopause Symptoms

Perimenopause symptoms can look different for every woman. Some women have mild symptoms. Others have symptoms that affect daily life.

Common symptoms include:

If symptoms are affecting your quality of life, it may be time to talk with a women’s health provider.

Development 1: New Non-Hormonal Medications for Hot Flashes and Night Sweats

One of the biggest changes in perimenopause treatment is the arrival of newer non-hormonal medications.

Hot flashes and night sweats are also called vasomotor symptoms. These symptoms happen when hormone changes affect the part of the brain that helps control body temperature.

Newer medications, including fezolinetant, sold as Veozah® , and elinzanetant, sold as Lynkuet® , work on this temperature control system in the brain. These medications do not use estrogen or progesterone.

How New Non-Hormonal Perimenopause Treatments Work

These newer medications are part of a group called neurokinin receptor antagonists. That name sounds complicated, but the idea is simple.

They help calm the brain’s “thermostat.”

During perimenopause and menopause, changes in estrogen can make the brain’s temperature control system more sensitive. This can trigger hot flashes and night sweats. These newer medications help block signals in the brain that are linked to those symptoms.

Fezolinetant blocks the NK3 receptor. Elinzanetant blocks both NK1 and NK3 receptors, which may help with hot flashes and may also support sleep for some women.

Why These New Hot Flash Treatments Matter

For many women, hot flashes are not just uncomfortable. They can interrupt sleep, cause daytime fatigue, and make it harder to focus.

Night sweats can be especially frustrating because they may wake you up several times a night. Poor sleep can then affect your mood, energy, memory, and stress levels.

New non-hormonal medications give women another option. This is especially helpful for women who have health reasons to avoid hormones, such as a history of certain cancers, blood clots, or other medical concerns.

These medications are not right for everyone. Some patients may need liver function testing before or during treatment. A provider can help decide if one of these options is safe for you.

Development 2: Updated Hormone Therapy Guidance and Labeling Changes

Another major development is the change in how hormone therapy is being discussed.

Hormone therapy, sometimes called menopausal hormone therapy or HRT, may help with symptoms such as hot flashes, night sweats, sleep problems, vaginal dryness, and pain with sex.

For years, many women and providers were cautious about hormone therapy because of strong warning labels based on older research. More recent reviews have found that the risks were often misunderstood or applied too broadly, especially for some women and some types of estrogen treatment.

In 2025, the FDA began removing certain “black box” warnings from many estrogen products used for menopause symptoms. This change is meant to help provide more current and balanced information about the benefits and risks of treatment.

What the Hormone Therapy Update Means for Women

This update does not mean hormone therapy is right for every woman.

It means women should have a clearer, more personal conversation with their provider.

For many healthy women who are under age 60 or within 10 years of menopause, hormone therapy may be an option when symptoms are affecting quality of life. But the decision depends on your health history, family history, symptoms, risk factors, and personal goals.

The key message is this: hormone therapy should not be feared automatically, but it should also not be used without a careful medical review.

Vaginal Estrogen and Local Treatment Options

One area getting more attention is low-dose vaginal estrogen.

Vaginal dryness, burning, urinary discomfort, and pain with sex are common during perimenopause and menopause. Low-dose vaginal estrogen is used directly in the vaginal area. Because it is local, much less estrogen is absorbed through the whole body compared with some other forms of hormone therapy.

Many women’s health experts have supported clearer labeling for vaginal estrogen because the older warnings did not always reflect the lower level of whole-body exposure.

This change may help more women feel comfortable asking about treatment for symptoms they may have been too embarrassed to discuss.

Development 3: Better Access to Perimenopause Care

The third important development is a growing focus on access.

For a long time, many women felt dismissed when they asked about perimenopause symptoms. Some were told symptoms were “normal” without being offered real help. Others had trouble finding providers who were comfortable treating menopause and perimenopause.

That is starting to change.

New legislation and government efforts are working to make perimenopause care a more standard part of healthcare in the United States. The Advancing Menopause Care and Mid-Life Women’s Health Act proposes $275 million to support more research, improve provider training, and expand care for women in midlife.

There is also progress at the state level. Some states, including Illinois and Louisiana, have passed laws requiring insurance coverage for menopause and perimenopause treatments. This may help more women access the care they need without as many financial barriers.

What Better Perimenopause Access Can Look Like

Better access to perimenopause care may include:

• More providers who understand perimenopause symptoms
• More conversations about treatment options
• Better education about hormone and non-hormonal choices
• More attention to sleep, mood, sexual health, and bone health
• More personalized care instead of a one-size-fits-all approach
• More women feeling comfortable asking questions

Perimenopause is not just about periods ending. It can affect your whole body and your daily life.

That is why care should look at the full picture. With better research, stronger provider education, and improved access to treatment, more women can get the support they need during this stage of life. 

Perimenopause Treatment in Iowa

Perimenopause care is entering a new era. Women now have more non-hormonal options, updated hormone therapy information, and better access to conversations about midlife health.

At The Gabrielson Clinic, we provide compassionate women’s healthcare for every stage of life, including gynecologic care, wellness visits, peri- and menopause management, and personalized treatment planning. Our team serves women across Iowa, with locations in Boone, Clarion, Webster City, and Clear Lake.

Schedule an appointment with The Gabrielson Clinic to talk through your symptoms and explore treatment options designed around your needs.