Gabapentin is a non-hormonal treatment used to manage moderate to severe vasomotor symptoms of menopause, particularly hot flashes and night sweats, especially in women who cannot take hormone therapy. Originally developed as an anticonvulsant, gabapentin helps regulate temperature control in the hypothalamus, which is thought to reduce the frequency and severity of hot flashes.

It is considered a second-line option, often used when hormone therapy is contraindicated or not tolerated. Gabapentin is typically taken at night and may also improve sleep disturbances associated with menopause. Common side effects include dizziness, drowsiness, and fatigue, which can affect daily functioning. It should be used cautiously in older adults due to increased risk of sedation and imbalance.