Transdermal Nitroglycerin Shows Limited Benefit for Hot Flashes

Systematic Review Evaluates Nitroglycerin Patches

Transdermal nitroglycerin may offer modest reductions in hot flash frequency for postmenopausal women, according to a systematic review presented at the 2026 Annual Meeting of The Menopause Society in San Diego.

Researchers led by Dr. Flavia Fairbanks Ruano from the University of Miami Miller School of Medicine reviewed four clinical studies examining continuous transdermal nitroglycerin patches. The analyzed studies included more than 160 total participants.

The review evaluated daily hot flash frequency alongside quality of life outcomes to assess whether the compound could serve as a nonhormonal alternative.

Trial Results Remain Inconsistent Across Studies

Clinical outcomes varied substantially across the four reviewed studies when comparing transdermal nitroglycerin to placebo controls.

In three of the four studies, any observed improvements in vasomotor symptoms were minimal. The comparative data showed inconsistent symptom control between active treatment groups and control arms.

One small single-arm study showed daily hot flash frequency dropped by up to 69% at the maximum tested dose. Symptoms returned once participants discontinued the patch, indicating that any suppressive effect was temporary.

Headaches Emerged as the Primary Adverse Event

Headaches were the most frequent adverse event documented across the trials, affecting up to two-thirds of participants early in treatment.

Nitroglycerin acts as a vasodilator, which frequently triggers vascular headaches when therapy begins. The review noted that this side effect posed a clear challenge to initial treatment adherence in the analyzed cohorts.

The Need for Nonhormonal Vasomotor Treatments

Hot flashes affect 75% to 85% of women during perimenopause and menopause, often altering sleep and quality of life.

An estimated 10% to 30% of women experience severe symptoms that disrupt work performance, mood, and daily activities. Frequent night sweats also contribute to chronic fatigue and related metabolic strain.

Hormone therapy remains the most effective medical standard for moderate to severe symptoms. Many women cannot take hormones due to medical contraindications or personal preferences, which drives ongoing demand for nonhormonal alternatives.

Evidence Remains Too Limited for Routine Use

Medical leadership notes that existing data on transdermal nitroglycerin are too imprecise and limited to support regular clinical adoption.

Dr. Stephanie Faubion, medical director for The Menopause Society, emphasized that larger, well-designed trials are necessary before determining whether the treatment has a practical clinical role. Patients experiencing severe vasomotor symptoms should discuss existing evidence-based nonhormonal therapies with their personal healthcare clinician.