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Non-hormonal pharmacological options include: Fezolinetant , a neurokinin 3 receptor antagonist, now recommended by NICE for treating moderate to severe vasomotor symptoms Selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs), which may be used off-label for vasomotor symptoms when HRT is contraindicated Clonidine or gabapentin , which can be considered as alternatives for hot flushes when other treatments are unsuitable Cognitive behavioural therapy (CBT) , which has good evidence for managing hot flushes, night sweats, and low mood Vaginal oestrogen for genitourinary symptoms, which can be used safely even in women who cannot take systemic HRT Lifestyle modifications form an essential component of menopause management and can complement any pharmacological treatment

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This suggests that the shape of GO can significantly influence its antibacterial properties 237

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