New Hope for Menopause Relief: Non-Hormonal Treatments Arrive

For decades, teh treatment of menopause symptoms, especially hot flashes, revolved exclusively around hormone replacement therapy. But this is changing with the arrival of a new generation of non-hormonal medications, developed to act directly on the brain mechanisms that control body temperature.

This change promises to offer relief to women who cannot or do not want to use hormones during this stage of life.

The first representative of this class is fezolinetant, approved in 2023 by the FDA (Food and Drug Management), a regulatory agency in the United States.Rather of replacing estrogen, it acts on the brain’s thermoregulatory center, blocking neurokinin 3, a neurotransmitter that becomes dysregulated when estrogen levels drop.

“When estrogen decreases, the system that regulates body temperature loses balance and becomes hyperstimulated. Fezolinetant acts precisely at this point, without having any effect on other symptoms of menopause. Therefore, it doesn’t replace the other benefits of hormonal therapy,” observes gynecologist and nutritionist Alessandra Bedin, from Einstein Hospital Israelita.

In clinical studies with more than 3,000 women, fezolinetant reduced the intensity of hot flashes by 64% and the frequency of hot flashes by 60% after three months of use, an advancement that began to be noticed in the first few days.

The medication is administered orally, once a day, and has shown good tolerability, with mild side effects. The primary concern is the rare risk of liver damage, which is why monitoring liver enzymes during treatment is necessary.

“The liver metabolizes this medication, so it’s crucial to monitor liver function. Though, the benefits for women who can’t or choose not to use hormone therapy are notable,” adds Dr. Bedin.

Key Takeaways

• Fezolinetant is a new non-hormonal treatment for menopause hot flashes. It offers an option for women who cannot or prefer not to use hormone replacement therapy.
• It works by blocking neurokinin 3 in the brain. This neurotransmitter is linked to body temperature regulation and becomes dysregulated during menopause.
• Clinical trials show significant reductions in hot flash intensity and frequency. Improvements were noticeable within the first few days of treatment.
• Liver enzyme monitoring is essential. While generally well-tolerated, there’s a rare risk of liver damage.

Looking Ahead: The arrival of fezolinetant marks a turning point in menopause treatment. Researchers are actively exploring other non-hormonal options targeting different pathways involved in menopause symptoms. This expanding toolkit will empower women to manage their menopause journey with personalized and effective solutions. Further research will focus on long-term effects and identifying which women will benefit most from these new therapies.