Can You Use Effexor for Hot Flashes and Other Menopause Symptoms?

Hot flashes, night sweats, and vaginal dryness are all hallmark symptoms of menopause. And if they’re happening to you, you might be looking at options for relief.

Menopausal hormone therapy (MHT) — previously called hormone replacement therapy — is a common option for managing menopause symptoms. But not everyone wants or is able to use hormones. So what’s the next step? One option for some women is taking certain antidepressants for menopause symptoms. Effexor (venlafaxine) is an antidepressant that’s sometimes prescribed off-label for hot flashes.

If Effexor is a menopause treatment you and your healthcare professional are considering, you likely have some questions about it. Let’s dive in and discuss some basics of Effexor’s possible role in hot flash relief.

EXPERT PICKS: WHAT TO READ NEXT

• Antidepressants for menopause: Read more about how Effexor (venlafaxine) and other antidepressants help with hot flashes.

• Possible side effects: Pharmacists review notable Effexor side effects — from nausea to sex drive changes — and how to manage them.

• Menopause treatment savings: Learn more about how you can save on menopause treatments.

What is Effexor?

Effexor is a brand name for venlafaxine. It comes as immediate-release (IR) tablets and extended-release (ER) tablets and capsules. It’s FDA approved to treat the following mental health conditions:

• Major depressive disorder (depression)

• Generalized anxiety disorder

• Social anxiety disorder

• Panic disorder

Brand-name Effexor IR is no longer on the U.S. market. It’s only available as a generic version. Effexor XR is available as both a brand-name and generic medication.

How does Effexor work for hot flashes?

Hot flashes during menopause are believed to be triggered by hormonal changes. One of these important changes is a drop in levels of the hormone estrogen. But other factors may also trigger hot flashes. And Effexor targets these other causes.

Effexor is a serotonin and norepinephrine reuptake inhibitor (SNRI). It raises levels of the chemicals serotonin and norepinephrine in your brain. In addition to their role as mood boosters, these chemicals help regulate body temperature.

While not fully understood, experts believe that a drop in estrogen may trigger an imbalance in these chemicals. Effexor works to balance serotonin and norepinephrine levels in the brain. And once balanced, these chemicals can help stabilize body temperature again.

What is the Effexor dosage for hot flashes?

Because hot flashes are an off-label use for Effexor, there is no standard dosage provided by the manufacturer. In clinical studies, participants took between 37.5 mg and 75 mg of Effexor daily. It’s best to work with your prescriber to find the right dose for you.

What are the potential side effects of Effexor for hot flashes and other menopause symptoms?

Effexor’s side effects in menopause studies were similar to what people typically experience when taking it for mental health conditions.

Common side effects

Common side effects of Effexor include:

• Nausea

• Dizziness

• Trouble sleeping

• Drowsiness

• Dry mouth

• Headache

• Low sex drive (libido)

• Loss of appetite

• Weight loss

• Constipation

Serious side effects

Effexor can cause more serious side effects. But keep in mind that these are rare:

• Suicidal thoughts

• Serotonin syndrome (a condition caused by too much serotonin in the brain)

• High blood pressure

• Low sodium levels

• Seizures

• Higher risk of bleeding

Be sure to discuss these risks with your healthcare team when first starting Effexor. If you or someone you know is having thoughts of suicide, you’re not alone, and help is available. Call the National Suicide Prevention Lifeline at 988, or text HOME to 741-741 to reach the Crisis Text Line.

How effective is Effexor for hot flashes and other menopause symptoms?

Research suggests Effexor seems to be effective for hot flashes. Some studies have found that it may reduce hot flash severity by as much as 61%. Researchers noted that Effexor began providing some relief about a week after participants started it.

Another study found that low-dose oral estrogen worked better than Effexor. But both estrogen and Effexor provided significant relief compared to a placebo (a pill with no medication in it). The authors suggested that Effexor is likely a good alternative if someone can’t or doesn’t want to take standard menopausal hormone therapy (MHT).

It’s important to note that Effexor only seems to be beneficial for hot flashes. It doesn’t seem to help with vaginal menopause symptoms, such as vaginal dryness and pain during sex.

Do you need a prescription for Effexor?

Yes, Effexor is only available with a prescription. If you’re interested in exploring it as a hot flash treatment, reach out to your healthcare team. A reproductive health specialist, like a gynecologist, is a great resource to discuss menopause symptom treatments. A primary care provider can also help determine if Effexor would be a good option for you.

Are there any Effexor alternatives for menopause symptoms?

A similar non-hormonal treatment for hot flashes is Brisdelle (paroxetine). This is another antidepressant. But unlike Effexor, it’s FDA approved for treating menopause hot flashes.

Veozah (fezolinetant) is also an FDA-approved non-hormonal hot flash treatment. It’s not an antidepressant, and it works differently from both Effexor and Brisdelle. This could be an alternative to consider if you’re looking to avoid both hormones and antidepressants.

Menopausal hormone therapy (MHT) is still recommended for menopause symptoms by experts. One benefit of MHT over antidepressants is that it can help with all symptoms, including vaginal dryness. So if you have both hot flashes and vaginal symptoms, MHT may be a better option.

If you’re looking for non-prescription menopause relief, there are some over-the-counter options you might see on pharmacy shelves. Herbal remedies like black cohosh and evening primrose oil are popular choices. But the evidence supporting their use isn’t strong. So it’s best to discuss these with your healthcare team first before trying them.

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Written by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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