Listen again · In Conversation
Health explained: Menopause treatment guidance October 18, 2026 · 4:23 · With Emma and Grace
We share news and stories in clear English to help us understand the world. I’m Emma, and Grace is our columnist for health and medicine. We’re looking at updated guidance on treating menopause symptoms.
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Emma Welcome to Slow English FM and Health Explained. We share news and stories in clear English to help us understand the world. I’m Emma, and Grace is our columnist for health and medicine. We’re looking at updated guidance on treating menopause symptoms. Emma Grace, what is the main change in this guidance? Grace MedPage Today reports that the American College of Obstetricians and Gynecologists, or ACOG, strongly recommends menopausal hormone therapy for certain symptoms in patients who are suitable for it. The guidance covers hot flashes and related sleep problems. It also says that, for appropriate patients, treatment should begin before age 60 or within 10 years of natural menopause. Emma Let’s clarify those symptoms. When you say hot flashes, what does that mean here? Grace Hot flashes are sudden feelings of heat. They are one example of vasomotor symptoms, the term used in the guidance. The recommendation also covers sleep problems related to those symptoms. It does not mean that hormone therapy is right for everyone. Emma Who does the recommendation apply to, and what treatment does it describe? Grace The report says it applies to appropriate patients who do not have a reason that rules out hormone therapy. The guidance describes systemic treatment. That means hormones given to act through the body. For patients with a uterus, it recommends estrogen together with a progestogen. For those who do not need protection of the lining of the uterus, it recommends estrogen alone. Emma So the treatment differs by whether a patient needs that protection. Does the report explain which conditions rule out hormone therapy? Grace The MedPage Today report does not list those conditions in the details we’re discussing. The important point in the recommendation is that it is for patients without contraindications. A contraindication is a reason a treatment should not be used. The guidance does not make this a one-size-fits-all choice. Emma Why does the timing matter in the updated guidance? Grace The recommendation sets out two timing points: before age 60, or within 10 years of the start of natural menopause. It says appropriate patients should begin treatment within that period. That is the guidance’s stated timing; it is not a claim that every patient should start treatment. Emma And what if hormone therapy is not suitable? Grace MedPage Today reports that ACOG also strongly recommends some nonhormonal medicines for patients who cannot use hormone therapy. These include two groups of medicines: selective serotonin reuptake inhibitors, or SSRIs, and serotonin and norepinephrine reuptake inhibitors, or SNRIs. The guidance lists them for hot flashes and depressive symptoms. It also recommends neurokinin receptor agonists for hot flashes and related sleep problems. Emma That is a different set of options for a different group of patients. How new is this guidance? Grace MedPage Today says the updated guidance replaces ACOG’s 2014 recommendations. It was published in the journal Obstetrics & Gynecology. The report also says that an outside expert, JoAnn E. Manson, described the recommendations as similar to those of the American College of Physicians and other professional groups. She was not involved in writing the guidance, so that comparison is her assessment. Emma To sum up: the updated guidance strongly supports hormone therapy for certain menopause symptoms in suitable patients, with a stated window for starting treatment. It also describes nonhormonal options for patients who cannot use hormones. Grace, thank you. Emma Thanks for listening to Health Explained on Slow English FM. I’m Emma. Goodbye.
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