Hot Flash Pills
vs
Stellate Ganglion Block

A side-by-side comparison of two menopause relief methods — efficacy, cost, how they work, and who shouldn't use them.

Side-by-side comparison

Method
Hot Flash Pills

Hot Flash Pills

A daily prescription pill (neurokinin receptor antagonist) that blocks NK3 receptors in the brain to reduce hot flashes and night sweats.
Stellate Ganglion Block

Stellate Ganglion Block

An injection of local anesthetic into a nerve bundle in the neck that may interrupt hot flash signals for several months.
EfficacyRecommended see details

Recommended by the Menopause Society for symptom relief.

Recommended (limited evidence) see details

Recommended with limited evidence by the Menopause Society.

Cost$0–$780 /monthly

Insurance: Usually

$500–$1,500

Insurance: No

DurationDaily pill (ongoing)Up to 6 months per injection (based on the Walega 2014 trial endpoint)
ReversibilityReversibleReversible
STI ProtectionNoNo
How it works

Blocks neurokinin-3 (NK3) and/or neurokinin-1 (NK1) receptors in the hypothalamus to interrupt the temperature-regulation pathway that triggers hot flashes and night sweats.

A clinician injects local anesthetic into the stellate ganglion, a nerve bundle in the neck that is part of the sympathetic nervous system. This may interrupt the temperature-regulation signals that trigger hot flashes.

PrescriptionRequired Prescription requiredRequired Prescription required
Available Products2 productsNo branded products yet
Side effects
  • Elevated liver enzymes (requires monitoring)
  • Abdominal pain
  • Diarrhea
  • Insomnia
  • Back pain
  • Hot flush
  • Headache
  • Somnolence, dizziness, and fatigue (more common with dual NK1/NK3 antagonists)
  • Temporary hoarseness
  • Drooping eyelid (Horner's syndrome, temporary)
  • Nasal congestion
  • Arm weakness (temporary)
  • Rare serious complications (seizure, cardiac arrest if injected into blood vessel)
Who shouldn't use this
  • Cirrhosis or severe liver disease (NK3 antagonists such as fezolinetant)
  • Severe renal impairment or end-stage renal disease (NK3 antagonists such as fezolinetant)
  • Concomitant use of CYP1A2 inhibitors such as fluvoxamine or ciprofloxacin (NK3 antagonists such as fezolinetant)
  • Pregnancy (dual NK1/NK3 antagonists such as elinzanetant)
  • Active anticoagulation therapy
  • Local infection at injection site
  • Severe bleeding disorder
  • Allergy to local anesthetic