What are the recommended first-line treatments for managing menopausal symptoms in primary care?

Offer hormone replacement therapy (HRT) to people with vasomotor symptoms associated with menopause ¹.

For women with a uterus, combined HRT should be offered, and for those who have had a total hysterectomy, oestrogen-only HRT should be offered ¹.

Consider menopause-specific cognitive behavioural therapy (CBT) as an option for vasomotor symptoms, either in addition to HRT or when HRT is contraindicated or not preferred ¹.

Do not routinely offer SSRIs, SNRIs, or clonidine as first-line treatment for vasomotor symptoms alone ¹.