PODCAST
Myth-Busting Wednesday: New ACOG Rules, Non-Hormonal Options, and a Surgery Worth Knowing About
October 21, 2026·9:48·Episode 150
Quick Summary
ACOG updated its menopause treatment guidelines for the first time since 2014, and several old assumptions didn't survive the revision. This episode also covers a new systematic review on non-hormonal treatments for depression and anxiety during perimenopause and postmenopause, and a strengthened ACOG recommendation that more midlife women should know about before they go into surgery.
Myth-Busting Wednesday: New ACOG Rules, Non-Hormonal Options, and a Surgery Worth Knowing About
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Key Takeaways
- ✦ACOG's 2026 guidelines update is the first since 2014 and explicitly strengthens support for hormonal therapy for women under 60 or within 10 years of menopause onset who don't have contraindications.
- ✦The "hormones or suffer" binary is a myth: a 2026 systematic review found several non-hormonal medications — including certain antidepressants and gabapentin — have meaningful evidence for menopause-related depression and anxiety.
- ✦Non-hormonal options are not all equal; the review found wide variation in how well individual drugs performed, and "non-hormonal" does not automatically mean low-risk or side-effect-free.
- ✦ACOG now recommends that doctors discuss removing the fallopian tubes — not just the ovaries — during unrelated pelvic surgeries, because most ovarian cancers actually start in the fallopian tubes.
- ✦Removing only the fallopian tubes during another surgery reduces ovarian cancer risk without triggering surgical menopause, which is a meaningfully different outcome than removing the ovaries.
Sources & References
Hot Flasher provides informational content only and does not constitute medical advice. Always consult a qualified healthcare provider for medical concerns.