However, the panel recommended against the use of gabapentin or pregabalin, as well as herbal or dietary supplements, such as soy, black cohosh, St. John’s wort, melatonin, and vitamin E to manage symptoms of hot flashes in either group of patients.

Of note, the strength of all of the intervention-based recommendations were classified as “conditional” because the certainty of their associated evidence was classified as “low” or “very low.”

Moreover, areas for which no recommendation was offered due to insufficient evidence in this setting included the use of hypnosis, relaxation therapy, cognitive behavioral therapy, acupuncture, and electroacupuncture. The guideline panel recommended that patients should undergo these interventions for the management of hot flashes only within the context of a clinical trial.

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In summarizing some of the clinical implications of these guidelines for nurses, the guideline panel stated that “conditional recommendations include the use of antidepressants rather than no treatment, physical activity rather than no treatment, and the avoidance of gabapentin and dietary supplements in the treatment of hot flashes.”


Kaplan M, Ginex PK, Michaud LB, et al. ONS Guidelines™ for cancer treatment-related hot flashes in women with breast cancer and men with prostate cancer. Oncol Nurs Forum. 2020;47:374-399.