Hot flushes, flashes, night sweats. Menopause experts like to call these VMS (vasomotor symptoms). Whatever you call them, many women know they can make midlife miserable. Soon, women will be able to get hot flash relief without hormones.
This isn't a gimmick. This is a well-studied non-hormonal therapy that targets the brain's temperature zone. No one is perhaps more excited about this new treatment than JoAnn Pinkerton, MD. She's director of the Midlife Health Clinic at UVA Health and former executive director of the North American Menopause Society.
"This medication, which is NOT an estrogen (a type of hormone), provides excellent relief of hot flashes and night sweats. And it may help with sleep."
She gives us the scoop on two key fronts:
- Reassuring news about hormone therapy (HT)
- How this nonhormonal treatment stands to revolutionize menopause treatment
Targeting the Brain's Temperature Zone
So what's the new medication? It's one of a new class of drugs known as neurokinin receptor antagonists. These agents act on the brain's 'temperature zone.' Around the time of menopause, when women's estrogen levels drop, this area of the brain narrows, triggering hot flashes.
Pinkerton explains: "These agents offer a targeted approach to treating VMS. They dampen neuronal activity in the thermoregulatory center of the brain, or the temperature zone."
When tested in perimenopausal and menopausal women, this medication reduced both the frequency and severity of hot flashes. It was comparable, or just as good as, HT. In less than 1 week, Pinkerton says, women in the clinical trial got hot flash relief without hormones.
Practice-Changing Treatment for Midlife Woes
There's one catch. This new therapy is not yet approved by the U.S. Food and Drug Administration for hot flash treatment. The FDA is reviewing data collected from clinical trials conducted at UVA Health and nationwide.
Currently, there's only 1 FDA-approved non-hormonal treatment for VMS. It's a low-dose paroxetine salt. Some antidepressants are also prescribed to help women get hot flash relief without hormones.
But unfortunately, Pinkerton shares, these are all "substantially less effective than HT in treating VMS."
What about lifestyle methods? Scientists have looked at the impact of these on menopause symptoms:
- Cognitive behavioral therapy
- Hypnosis
- Acupuncture
But again, Pinkerton says, the science isn't clear on how effective these are at bringing hot flash relief without hormones. That's why she's excited about the new drugs. They could change the practice of midlife healthcare, especially since HT is not recommended for women who've had breast cancer. But for now, it’s important to know that HT is safe and effective for many women. First, we explore HT's backstory.
Why We Began to Fear Hormone Therapy
Pinkerton has spent her career looking for ways to help women thrive during perimenopause and menopause. She traces the history of hot flash treatment.
"We started with no therapy for hot flashes. Women just suffered. Then we had one product available. Women were started on hormone therapy as a 'replacement.' They were expected to stay on it for life."
Then fear began driving all conversations about hormone therapy. It came in the wake of the first findings from a large study known as the Women's Health Initiative. Findings released in 2002 raised concerns about connections between HT use and breast cancer, heart disease, blood clots, stroke, and even dementia.
Pinkerton says, "Women then tried less effective non-hormone therapy. Or they searched out compounded non-FDA approved hormones." Untested, these therapies brought new concerns about:
- Lack of effectiveness
- Safety
- Contaminants
Menopause Making Life Miserable?
Don't suffer in silence.
Brighter Days for Hormone Therapy
Here's some reassuring news. Based on decades of research, all major medical societies agree on one thing.
Hormone therapy is safe and effective for healthy women who are:
- Under age 60
- Within 10 years of menopause
Pinkerton says, "HT not only treats bothersome VMS. It also helps prevent osteoporosis and changes like vaginal dryness."
"The future is bright for women who are candidates for hormone therapy," Pinkerton says. "We can tailor HT based on the risks and benefits. We have many low-dose options. And we have FDA-approved bioidentical hormone therapy that can be taken in a variety of ways."
Women's Health Breakthrough: Hot Flash Relief Without Hormones
Now back to the new drug. Here's the scoop from Pinkerton.
"One of these drugs is currently being reviewed by the FDA. Hopefully, it will soon be available to bring relief for hot flashes without hormones. We are also investigating a sister drug. In early clinical trials, it provides relief of hot flashes and night sweats, improves sleep, and is expected to improve mood."
She adds, "We're very excited to be a part of a new breakthrough in women's health."
