CLEVELAND, Ohio (October 20, 2026)—Hot flashes are the most frequent symptom of perimenopause and menopause, affecting 75% to 85% of women. In recent years, there has been a spike in the number of nonhormone options for managing hot flashes. A new study suggests that transdermal nitroglycerin may be an option. Results of the study will be presented at the 2026 Annual Meeting of The Menopause Society in San Diego October 20-24, 2026.
Menopausal hot flashes are not life-threatening, but frequent or severe episodes can significantly disrupt daily life. It is estimated that between 10% and 30% of women have symptoms that are severe enough to impair daily activities, work performance, and overall quality of life. Night sweats can disrupt sleep, leading to chronic fatigue, irritability, and mood changes.
Hormone therapy is widely considered the most effective (gold standard) medical treatment for moderate-to-severe hot flashes. However, not all women are willing or able to take hormones, which has led to an increase in the number of nonhormone treatments on the market today. Researchers in a new study sought to evaluate the impact of continuous transdermal nitroglycerin on hot flash frequency and related quality-of-life outcomes.
They reviewed four studies which included more than 160 participants in total. Results were inconsistent when comparing nitroglycerin to placebo and, in three of the four studies, any improvements recognized were minimal. However, in a small single-arm study, daily hot flash frequency decreased by up to 69% at the maximum nitroglycerin dose, with recurrence after discontinuation. Headaches were the most frequent adverse events, affecting up to two-thirds of participants early in treatment.
Based on the results, the researchers concluded that continuous transdermal nitroglycerin may provide modest reductions in hot flash frequency and represents a potential nonhormone option for postmenopausal women with contraindications to hormone therapy. They agreed, however, that evidence is limited, imprecise, and inconsistent, and further well-powered trials are needed to clarify efficacy, safety, and clinical utility of the transdermal nitroglycerin in this population.
"Finding effective nonhormonal treatments for hot flashes is important because many women are unable or prefer not to use hormone therapy, yet these symptoms can significantly affect sleep, daily functioning, and quality of life. Our findings suggest that transdermal nitroglycerin is an interesting potential nonhormonal approach, but the current evidence is still limited. Larger, well-designed trials are needed to determine whether this treatment can provide a meaningful benefit for patients," says Dr. Flavia Fairbanks Ruano, lead author from the University of Miami Miller School of Medicine.
Details of the study will be discussed as part of the presentation entitled "Transdermal Nitroglycerin for Hot Flashes in Postmenopausal Women: A Systematic Review."
"Hot flashes can have a profound effect on sleep, daily functioning, work productivity, and quality of life," says Dr. Stephanie Faubion, medical director for The Menopause Society. "Although hormone therapy remains the most effective treatment for most women, there is an ongoing need for safe and effective nonhormone options. This review highlights transdermal nitroglycerin as a potentially promising approach, but the available evidence remains limited and inconsistent. Larger, well-designed studies are needed before its role in clinical practice can be determined."
