Vasomotor Symptoms During Menopause: A Practical Guide on Current Treatments and Future Perspectives

Abstract

Vasomotor symptoms affect as many as 80% of midlife women, but only about one in four women receive treatment due to many factors. Menopausal hormone therapy remains the most effective treatment for vasomotor symptoms, and current professional guidelines conclude that the benefits of treatment typically outweigh the risks for healthy, symptomatic women under age 60 years and those within 10 years from their final menstrual period. For women with medical comorbidities, an individualized approach to treatment is recommended. For women who cannot use or choose not to use menopausal hormone therapy, there are many evidence-based non-hormonal options available including pharmacologic therapies. This review aims to summarize treatment options for bothersome vasomotor symptoms to guide clinicians caring for midlife women.

Treating moderate-to-severe menopausal vasomotor symptoms with fezolinetant: analysis of responders using pooled data from two phase 3 studies (SKYLIGHT 1 and 2)

“…Non-FDA–approved medications that have been shown to have efficacy against VMS include clonidine, gabapentin, selective serotonin reuptake inhibitors, and serotonin-norepinephrine reuptake inhibitors. Fezolinetant and low-dose paroxetine are currently the only nonhormone treatments approved by the US Food and Drug Administration for the treatment of VMS, 36 but several other potential nonhormone options are undergoing late-stage clinical development 37,38 …”

“…Fezolinetant and low-dose paroxetine are currently the only nonhormone treatments approved by the US Food and Drug Administration for the treatment of VMS, 36 but several other potential nonhormone options are undergoing late-stage clinical development. 37,38 A key strength of the present study is the inclusion of a large participant population (n = >1,000) from two randomized, double-blind, placebo-controlled trials. Other strengths include that the study duration was consistent with other clinical trials in VMS, [39][40][41] because the inclusion of placebo for long periods is difficult from a patient perspective, and the use of MENQoL Total Score, which captures multiple HRQoL aspects (vasomotor, psychosocial, physical, and sexual function).…”

Short-term effects and safety of a natural oral supplement containing glucosinolates, phytosterols, and citrus flavonoids compared with hormone treatment for the management of postmenopausal symptomatic women: a pilot single-center randomized phase 2 clinical trial

“…[51][52][53] Nonetheless, EPT has been shown to offer several potential benefits in managing the menopausal symptoms, which are difficult to overcome. Specifically, EPT has been found to significantly reduce the frequency and intensity of hot flashes, 54 improve urogenital atrophy, 55 and reduce the risk of osteoporosis and subsequent fractures. 56 In addition, EPT has been associated with cardioprotective effects, such as improving lipid profiles and reducing inflammation and arterial stiffness.…”

The effect of radiofrequency treatment on insulin resistance in obese post-menopausal women: a randomized controlled trial

“…Menopause is the time that menstrual periods stop permanent, which occurs between the ages of 45 and 55. The transition from pre-to post-menopause lasts about 4 years with irregular menses and is marked by unique endocrinological, biological, and clinical changes (Khan et al, 2023). Hot flushes, night sweats, mood fluctuations, joint pain, and dryness in the vaginal area are very common symptoms during the menopausal transition, along with physical consequences like reduced bone density, central obesity, unfavorable alterations in cholesterol levels, vascular changes, and insulin resistance (IR) (Davis & Baber, 2022).…”