ACOG updates menopause treatment guidelines for the first time since 2014

The American College of Obstetricians and Gynecologists released updated guidelines Thursday for treating menopause symptoms, the first update since 2014. The new guidance recommends hormone replacement therapy alongside antidepressants and newer nonhormonal medicines like fezolinetant (approved 2023) and elinzanetant (approved 2025), and affirms the safety of hormone therapy based on re-examined evidence from prior research.

Guidelines recommend hormone therapy primarily for symptomatic women within 10 years of their final menstrual period or before age 60. Individual eligibility varies.