Menopause is the permanent cessation of menstrual periods that occurs naturally or is induced by surgery, chemotherapy, or radiation. With improved healthcare and increased life expectancy, women may spend 30 years on average after the menopause. There are several symptoms associated with menopausal transition, and 75% of women will experience some of these. Vasomotor symptoms (VMS) are the most commonly reported, and often the most difficult to manage effectively with non-hormonal therapies. The most commonly used alternatives will be covered in this chapter. Among them, the effectiveness of the lifestyle measures to improve vasomotor symptoms, the alternatives to hormone therapy most often prescribed, the recently incorporated antagonists of the neurokinin receptors, the non-pharmacological therapies, and the non-hormonal management of vulvovaginal symptoms.