For many women, menopause feels is like a roller coaster, with unexpected twists and turns that can leave them feeling out of control. From depression to mood shifts, headaches to sleep disturbances, menopausal symptoms can take a toll on both physical and emotional well-being. While caused by fluctuating hormones, one major menopausal symptom is linked to many others.
Tackling hot flashes and night sweats might be the most effective method to alleviate other menopausal symptoms. As a result of a recalibration 20 years ago, we are entering an era laden with non-hormonal therapeutic research results.
Known as vasomotor symptoms (VMS), hot flashes are the core symptom of menopause, occurring in up to 85% of those transitioning through this life stage. When estrogen fluctuates at the beginning of menopause, the female body can no longer rely on estrogen to maintain body homeostasis. While the body adjusts, it can wreak havoc in the meantime, contributing to many other menopausal symptoms, such as headaches, mood changes, anxiety, and exhaustion.
These disturbances can last longer than the VMS itself. The "domino theory" proposes that physical symptoms such as VMS might progress to mental disorders. Hormone changes create VMS, which often disrupts sleep. When sleep attempts fail, time in bed ceases to be connected with rest, and sleep disorders may become chronic. This rising sleep deprivation can lead to depression.
The field of menopausal treatments is currently bursting with non-hormonal advancements, thanks to some faulty research 20 years ago. The Women’s Health Initiative (WHI) studies in the early 2000s panicked the research community by linking hormonal replacement therapies to coronary heart disease and dementia. While over time, most of the worries raised by the WHI studies were proven spurious, research was funded, conducted, and revealed new avenues for effective non-hormonal treatments for misregulated body temperature.
Researchers at UC San Francisco took a daring detour from traditional hormonal therapies by focusing on surface blood vessels as the key to combating VMS. “In this line of research, we repurposed a medication that has been used for close to a century for a different indication,” says lead author and UCSF Health physician Alison J. Huang, MD.
Huang's team explored whether nitroglycerin patches provide continuous relief for VMS. However, addressing the vascular symptom directly in their double-blind placebo-controlled clinical trial did not change VMS severity. “The bottom line,” explains Huang, “is that our study doesn't allow us to recommend nitroglycerin skin patches as a strategy for consumers to suppress hot flashes in the long term.”
Thankfully the results keep pouring in and a beacon of hope emerged last month in the form of a groundbreaking non-hormonal drug called Veozah. This revolutionary treatment targets the neurokinin 3 (NK3) receptor, a key player in regulating body temperature in the brain. After one week of Veozah treatment, improvements in the frequency and severity of vasomotor symptoms were manifested and continued through the 52-week study.
Non-hormonal treatments are gaining traction and offering tangible relief for menopausal VMS. This is crucial for those unable to take hormone treatments due to hormone-sensitive cancers. Aging adults can look to the future with excitement, knowing that the battle against menopause's challenges is being fought on multiple fronts.
Sources: FDA, Journal Endocrinology Metabolism in Clinical North America, Ageing Research Review, JAMA Internal Medicine, The Lancet, Journal of Clinical Sleep Medicine