Evidence-based nonhormonal choices include cognitive behavioural therapy, clinical hypnosis, SSRIs or SNRIs such as paroxetine or venlafaxine, gabapentin, oxybutynin, and fezolinetant. Selection should match the patient’s comorbidities and treatment priorities: - An SSRI or SNRI may suit a patient who also has depression or anxiety, but review adverse effects and interactions before prescribing. - Gabapentin can be useful when night sweats coexist with sleep disruption; dizziness and somnolence affect fall and driving risk. - Oxybutynin may reduce VMS but adds anticholinergic effects, including dry mouth, constipation, urinary retention, and possible cognitive burden. - Fezolinetant targets neurokinin-3 signalling and is a nonhormonal option when estrogen is unsuitable or undesired. Clonidine, supplements and herbal remedies, soy, cannabinoids, acupuncture, and paced respiration are not recommended as evidence-based treatments for VMS. “Natural” does not mean predictable or interaction-free; compounded bioidentical hormones are also not recommended because dose consistency, quality oversight, and outcome evidence are inferior to those of regulated products. For Canadian NP practice / CNPLE-aligned preparation (Canada), items rarely announce the topic in the first sentence. Anchor to objective data, trajectory, and the...