US gynecologists broaden menopause treatment guidelines, back hormone therapy

Trending into 17 October 2026, the American College of Obstetricians and Gynecologists' newly expanded menopause guidance remained one of the most-read health stories worldwide. Published 15 October, ACOG's first major update since 2014 covers vasomotor symptoms, sleep and mood changes. The college gave menopausal hormone therapy a 'strong' recommendation as the first-line option for hot flashes, night sweats and related sleep problems, advising initiation before age 60 or within ten years of natural menopause. For women who cannot or do not want hormones, ACOG endorses newer non-hormonal drugs fezolinetant and elinzanetant, as well as some antidepressants that also ease hot flashes. Non-drug options include cognitive behavioural therapy, mindfulness, exercise, hypnosis and acupuncture. The guidance says current evidence is insufficient to recommend specific menopause-related depression treatments, so women meeting criteria for major depressive disorder should be managed under standard depression guidelines. ACOG said complementary guidance on genitourinary syndrome of menopause will follow in 2027. The update coincides with reported US shortages of hormone patches and comes as menopause has risen on the public-health agenda across the US, UK and Australia. US News, NPR, Healio, Patient Care Online and others ran prominent explainers.