What is the recommended treatment for a woman experiencing vasomotor symptoms of menopause and has a history of DVT?

For a woman experiencing vasomotor symptoms of menopause, particularly one with a history of deep vein thrombosis (DVT), the recommended treatment is a selective serotonin reuptake inhibitor (SSRI), such as paroxetine.

This recommendation is grounded in the understanding that estrogen therapies, whether oral or topical, can increase the risk of thromboembolic events, which includes DVT. Given the patient’s history of DVT, using estrogen can pose significant risks. Paroxetine, as an SSRI, functions effectively in alleviating vasomotor symptoms without the associated risks of clot formation linked to hormone replacement therapy.

In summary, paroxetine is the safest and effective option for managing vasomotor symptoms in this scenario, avoiding the complications that might arise from estrogen-based therapies.