Eight important updates about menopause symptoms and treatment options, explained in everyday language.
A note before we begin: I am not a medical doctor. I am a Certified Menopause and Wellness Practitioner and a woman who experienced surgical menopause at 31. I created this resource to help women understand the updated guidelines using vetted, credible sources. It is for educational purposes only and is not a substitute for individualized medical advice. Please discuss treatment decisions with your healthcare professional.
Hey you, it’s me! 💋
Can we talk about menopause for a minute? Because something significant happened this month, and I think every woman deserves to know about it.
On October 15, 2026, the American College of Obstetricians and Gynecologists (ACOG) published updated guidance on managing hot flashes, night sweats, and menopause-related sleep and mood symptoms. Reading it took me back to the beginning of my own story.
I entered surgical menopause at 31. Thirty-one. At an age when many of my friends were nowhere near this conversation, I was already trying to understand what menopause meant for my body and my future. Now, more than a decade later, I still believe women deserve understandable information and space to ask questions without feeling dismissed.
That experience is part of why I became a Certified Menopause and Wellness Practitioner. I want these conversations to feel more approachable, especially for someone who has just been told that what she is experiencing is “normal” without being given much guidance about what to do next.
One important distinction before we dive in: these particular ACOG recommendations focus on managing symptoms around the usual menopause transition. My experience at 31 raises additional questions about early loss of ovarian hormones, which deserve their own individualized medical discussion. I’ll come back to that below.
So grab your coffee. Here are eight updates worth understanding, along with questions you can bring to your next appointment.
ACOG Clinical Practice Guideline No. 13 addresses vasomotor symptoms, the medical term for hot flashes and night sweats, plus associated sleep and mood concerns. It is not a complete guide to every menopause issue. Vaginal dryness, painful sex, and urinary symptoms are outside its main scope, with separate guidance anticipated.
For eligible patients dealing with bothersome hot flashes and night sweats, systemic menopausal hormone therapy has strong support. The word “eligible” matters: a person’s medical history, age, symptoms, and risks all influence the decision. Hormones can be very helpful, but they require a personal conversation about benefits, risks, and treatment choices.
Ask your clinician “Based on my symptoms and medical history, am I a candidate for systemic hormone therapy?”
Starting treatment before age 60 or within roughly 10 years of menopause is often associated with a more favorable benefit-risk balance for eligible patients. That is a clinical starting point, not a substitute for an individualized assessment. Women who experienced menopause much earlier, including after surgery, need guidance tailored to that history.
Ask your clinician “How does my age at menopause affect my treatment options and long-term health?”
A birthday alone should not decide when someone stops hormone therapy. Continued treatment calls for periodic review of symptoms, health changes, personal preferences, and risks with a clinician. If you have heard that everyone must stop at a certain age, this is a good reason to revisit the conversation.
Ask your clinician “How often should we review my treatment, and what changes would make us reconsider it?”
Not everyone can or wants to use hormone therapy. Prescription alternatives for hot flashes include fezolinetant (Veozah), elinzanetant (Lynkuet), and certain SSRIs or SNRIs. These treatments work differently and have different precautions. In particular, the newer neurokinin-targeting medications have liver-safety considerations that require clinician-directed monitoring.
Ask your clinician “Which nonhormonal option best fits my symptoms, other medications, and medical history?”
Gabapentin remains an option for some people with hot flashes, particularly when other approaches are unsuitable. Drowsiness and dizziness are common concerns. Serious breathing problems are a recognized risk in some circumstances, including use with opioids or other sedating drugs. A reported association between gabapentin and dementia in an observational study does not establish that gabapentin causes dementia. Never stop prescribed gabapentin abruptly without medical guidance.
Ask your clinician “Could gabapentin help me, and what interactions or side effects should we watch for?”
Cognitive behavioral therapy and some other nonmedication approaches can support symptom management, particularly sleep and coping. Evidence varies considerably across techniques, so avoid treating exercise, mindfulness, acupuncture, and clinical hypnosis as if they all have the same evidence for hot flashes. Movement and good sleep routines can still support overall well-being.
Ask your clinician “Which evidence-based nonmedication approaches could help my biggest symptoms?”
A product being marketed for menopause does not mean it has been shown to work. Evidence for many herbal supplements and soy isoflavones is insufficient to recommend them as reliable treatments for hot flashes and related symptoms. Supplements can also interact with prescriptions, and product quality varies. Bring the actual bottles or a complete list to your visit.
Ask your clinician “Are any of my supplements likely to help, cause side effects, or interfere with treatment?”
Vaginal dryness, pain with sex, and recurrent urinary symptoms deserve attention even though they are not the focus of this guideline. Effective treatments already exist, including options that may be appropriate for people who do not use systemic hormones. Do not wait for another guideline to ask about symptoms affecting your quality of life.
Ask your clinician “I’m having vaginal or urinary symptoms too. What treatment options are appropriate for me?”
This part is personal for me. Surgical menopause at 31 meant I had to think about menopause much earlier than I expected. The term “surgical menopause” generally refers to menopause caused by removal of both ovaries; a hysterectomy alone does not necessarily cause immediate menopause if the ovaries remain.
When ovarian hormone production ends before age 40, clinicians often consider questions beyond immediate hot flashes: bone health, cardiovascular risk, sexual and urinary symptoms, and whether hormone treatment is appropriate through the usual age of natural menopause. Recommendations for early menopause or premature ovarian insufficiency should be consulted separately from this 2026 symptom-management guideline. Individual circumstances, including the reason for surgery and any contraindications, are essential.
If you are in this group, ask for a plan that considers your long-term health as well as how you feel today. You deserve answers that fit your actual history.
Write down your two or three most disruptive symptoms and how often they occur. A two-week symptom log can help.
Bring a full list of prescriptions, over-the-counter medicines, supplements, and sleep aids.
Mention ACOG Clinical Practice Guideline No. 13 (October 2026), and ask which parts apply to you.
Ask about hormonal and nonhormonal choices, including side effects, monitoring, and follow-up.
If you entered menopause before 40, ask whether early-menopause-specific guidance changes your care plan.
If you feel unheard, ask for a referral to a clinician with expertise in menopause care.
Related resource: 12 Menopause Questions Most People Forget to Ask Their Doctor, including a printable checklist and symptom log.
No treatment is right for everyone. Eligibility depends on personal history and risks, and a clinician can help weigh the options.
Yes. Symptom duration varies, and persistent symptoms are worth discussing even years after the final menstrual period.
There is no universal automatic stop date. Continuing therapy requires individualized, ongoing review.
Evidence-based nonhormonal prescriptions and selected behavioral approaches may help, depending on your symptoms and health history.
It can, especially if both ovaries were removed before 40. Ask about early-menopause guidance and longer-term health considerations.
Perimenopause is the transition leading up to menopause. Natural menopause is generally identified after 12 consecutive months without a menstrual period when no other cause explains it.
Describe the impact on sleep, work, relationships, and daily functioning. Ask for a specific care plan or referral.
Not as a primary focus. Those symptoms still warrant assessment and treatment now.
Hormonal changes can influence hot flashes, sleep, and other aspects of daily well-being. Your experience also depends on health history, medications, stress, and other factors. Bring persistent symptoms to your healthcare professional for an individualized assessment.
No single factor explains weight changes for everyone. Aging, activity, sleep, medications, health conditions, and hormonal changes may all contribute. A qualified clinician can help you look at the full picture.
Regular movement, strength training, sleep routines, and balanced nutrition can support overall health during midlife. Specific treatments for hot flashes or other symptoms should be chosen based on the evidence and your individual needs.
Ask how your age at surgery, whether your ovaries were removed, medical history, and long-term bone and cardiovascular health affect your treatment options. Guidance for menopause before 40 may differ from recommendations for typical-age menopause.
Coming December 1, 2026 · Just Jelly Unfiltered, Season 5
Menopause conversations rarely stop at hot flashes. They often lead to questions about metabolism, weight changes, strength, energy, sleep, and how we feel in our changing bodies. I have plenty of those questions myself, especially after entering surgical menopause at 31.
On December 1, I’m welcoming Mandy White Eskelin, the wellness coach behind Reignite HER, to Just Jelly Unfiltered for an episode called “Breaking the Myths About Midlife and Hormones.” We’ll explore common claims about hormones and metabolism, what we can reasonably expect as we age, and how nutrition, movement, and sleep fit into the picture.
I want this to be a thoughtful conversation that makes room for questions, personal experiences, and the science. Coaching perspectives and personal stories are not substitutes for clinical evidence, and we’ll be careful about what research does and does not establish.
Have you been told something about hormones, weight gain, or aging that never quite sat right with you? Send me your question in the Pen Pal section of The Sweet Spot. I’d love to bring it into the conversation.
Listen Tuesday, December 1, 2026, at 6 AM ET. We’ll tag Mandy so you can connect with her: Instagram @mandy_white_eskelin and Facebook.
When Your Body Starts Hurting and No One Can Tell You Why: Menopause, Estrogen, and Pain
12 Menopause Questions Most People Forget to Ask Their Doctor
If there is one thing I hope you take away from this conversation, it is that you deserve to understand what is happening in your body. I was 31 when menopause became part of my story, and more than a decade later, I am still learning, asking questions, and paying attention as the research evolves.
You do not have to walk into your next appointment knowing every medical term. You can walk in knowing that your questions matter and that you deserve to be part of decisions about your health.
So whether you are just noticing changes, navigating surgical menopause, or still having symptoms years later, I hope this resource helps you start a conversation. What is one thing you wish someone had told you about menopause before you experienced it? Write me back in the Pen Pal section of The Sweet Spot.
Want to dive deeper? Sign up for The Sunday Scoop so you don’t miss the conversations, resources, and new episodes happening around here. You especially won’t want to miss “Breaking the Myths About Midlife and Hormones,” coming December 1, 2026, on Just Jelly Unfiltered, Season 5, with Mandy White Eskelin. We’ll be talking about midlife, menopause, hormones, and wellness, and I’d love for you to join the conversation. Subscribe at justjellypodcast.com and share this resource with someone who could use it.
Until our next chat, just stay sweet!
I love you,
Jenn 💋
Jenn Board is an author, life coach, Certified Menopause and Wellness Practitioner, creator of the P.A.U.S.E. Framework™, and host of Just Jelly Unfiltered. Having entered surgical menopause at 31, she brings personal experience to accessible conversations about menopause and midlife wellness. Her book is Silent to Spoken: A Woman’s Journey Through the Pause.
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ACOG guideline expands menopause VMS, sleep, and mood recommendations
ACOG Expands Treatment Options for Menopause-Related Symptoms
ACOG Issues Expanded Guideline on Managing Menopause-Related Vasomotor, Sleep, and Mood Symptoms
Hot flashes, night sweats, insomnia: OB-GYNs set new rules for menopause treatment
Menopause hormone therapy gets stronger endorsement from OB-GYNs
Use of gabapentin for the management of natural or surgical menopausal hot flashes
Study Explores Dementia Risk, Cognitive Impairment With Gabapentin
New Menopause Guidelines: Hormone Replacement Therapy is First-Line Treatment
ACOG Now Strongly Recommends Hormone Therapy for Hot Flashes and Night Sweats
This article is educational and does not replace individualized medical care. Seek prompt evaluation for any bleeding after menopause. Call emergency services for sudden chest pain, severe breathing difficulty, one-sided weakness, or slurred speech. Do not start, stop, or change medications without clinician guidance.