Review: In menopause (intact uterus), estrogen + progestogen, isoflavones, and black cohosh reduce hot flashes.

Reviewmethods MEDLINE, EMBASE/Excerpta Medica, and Cochrane Library (all to Jan 2015) and reference lists were searched for randomized controlled trials (RCTs). 47 RCTs (n = 8326) assessing 16 treatment classes (placebo, sham acupuncture, nonoral estrogen plus progestogen, oral estrogen plus progestogen, conjugated estrogens plus bazedoxifene, tibolone, raloxifene, selective serotonin reuptake inhibitors or serotonin–norepinephrine reuptake inhibitors, gabapentin, isoflavones, Chinese herbal medicine, black cohosh, multibotanicals, valerian root, relaxation, and acupuncture) met selection criteria. Risk for bias was low (14 RCTs), moderate (19 RCTs), high (12 RCTs), or very high (2 RCTs). 32 RCTs (n = 4165, 12 treatment classes) reported VMSs, 21 RCTs (n = 4829, 10 treatment classes) reported treatment discontinuation, and 5 RCTs (n = 1367, 5 treatment classes) reported vaginal bleeding.