How it works
Oxybutynin is a prescription drug approved for overactive bladder, but it is also used off-label for menopause hot flashes. It is an anticholinergic that blocks acetylcholine receptors, including in the brain, and can decrease sweating.
How well it works
A 2016 randomized controlled trial by Simon et al. found that 73% of women taking extended-release oxybutynin rated their symptom improvement “much better” at 12 weeks, compared to 26% with placebo. The NAMS 2023 position statement lists it as a Levels I-II recommendation.
Side effects and cautions
Oxybutynin is not FDA-approved for hot flashes, so this use is off-label. In the Simon 2016 trial, dry mouth affected over half of women taking oxybutynin. Other side effects include constipation, dizziness, and drowsiness. NAMS 2023 notes that long-term use of anticholinergics may be associated with cognitive decline, particularly in older people, and a review describes evidence that oxybutynin may increase the risk of dementia (Chancellor 2024 review). You should not take oxybutynin if you have uncontrolled narrow-angle glaucoma, urinary retention, gastric retention, or a known allergy to the drug.
Where to get it
You need a prescription from a clinician, such as your primary care provider. Generic oxybutynin is inexpensive. Check our provider directory for clinics near you.
