As a clinician who has many patients experiencing the challenges of menopause, I can barely imagine the emotional roller coaster that comes with it.
My patients often describe a sense of isolation and lack of support during this transformative phase.
Many of you may have felt the impact on your well-being and the prolonged suffering caused by symptoms like hot flashes and night sweats.
For instance, I had a patient last week who reported experiencing severe hot flashes at an important work meeting.
Moreover, she woke up every hour at night sweating.
Given estrogen and progesterone feed her cancer, she could not take hormonal replacement therapy.
I offered a non-hormonal option, which is this essay’s main topic.
The Statistics
I’ll begin with this disturbing statistic:
Vasomotor symptoms of menopause — such as hot flashes or night sweats — are common, affecting more than four out of five menopausal women.
Moreover, some women experience moderate-to-severe hot flashes and night sweats for an average of 7.4 years or more.
Today, I’ll explain why I write about menopause.
I will also discuss hot flashes, with a focus on a new non-hormonal drug aimed at alleviating suffering.
Why I Write About Menopause
Menopause is a universal experience for half of humanity, but its effects are far from uniform.
While some women navigate this transition with minimal disruption, others grapple with debilitating symptoms that significantly impact their well-being and can linger for extended periods.
Many women feel isolated and unsupported during this transformative phase.
The Emotional Roller Coaster of Menopause
We Need A Comprehensive Approach
A comprehensive approach is necessary to improve the experience for all women.
This strategy means:
- providing women with accurate information
- decision-making tools
- compassionate medical care
- workplace accommodations when required.
We should give special attention to women experiencing early or medically induced menopause, as well as those vulnerable to mental health challenges.
I acknowledge that societal biases against aging women can exacerbate negative menopause experiences.
Therefore, efforts to destigmatize menopause and celebrate the value and contributions of older women are crucial.
What Are Hot Flashes?
Hot H.F.sshes (H.F.s) are sudden sensations of heat, sweating, flushing, anxiety, and chills lasting one to five minutes.
My patients often report that they first have sudden, intense warmth that typically begins in the chest, neck, or face.
The warm sensation then spreads throughout the body, often accompanied by sweating, flushing, and (for some) a rapid heartbeat.
While hot flashes are often the product of hormonal drops secondary to premenopause or menopause, some have the symptoms because of a medical condition or medications.
Are There Hot Flash Risk Factors?
Risk factors
Some women experiencing menopause do not have hot flashes.
We need to understand better why some have them.
Still, some factors that may increase hot flash risk:
- Smoking
- Obesity
- Race. Black women report more hot flashes than other races. Asian women report the least.
Hot Flash Triggers
I always discuss potential triggers with my patients who are experiencing hot flashes.
Here are some more potential hot flash triggers:
Mayo Clinic Minute: Why alcohol and menopause can be a dangerous mix – Mayo Clinic News Network
Let’s get to the recently approved non-hormonal drug that alleviates hot flashes.
What is Veozah?
VEOZAH (generic name: fezolinetant) is a neurokinin 3 NK3 receptor antagnoist.
It is a non-hormonal prescribed medicine to manage hot flashes and night sweats.
Here’s what that means.
Your brain has receptors known as NK3.
These receptors respond to neurokinins (a brain chemical messenger) and estrogen.
As estrogen levels decline during the menopause transition, neurokinins show increased activity.
This neurokinin-increased activity makes them less likely to respond accurately to body temperature changes.
By binding to (and blocking) NK3 receptors, Veozah stops this activity, reducing hot flash severity.
Veozah Approved for Menopause-Related Vasomotor Symptoms
Veozah is approved (by the Food and Drug AdministrationU.S.in the U.S. for moderate to severe hot flashes and night sweats related to menopause.
What is VEOZAH® (fezolinetant) | VMS due to Menopause
Discover VEOZAH® (fezolinetant): a treatment option for moderate to severe hot flashes and night sweats caused by…
How is Veozah Taken?
Your healthcare provider will determine the appropriate dosage of Veozah, typically taken as one tablet once daily.
Women can take Veozah with or without food, ideally simultaneously each day, for optimal results.
It’s important to swallow the tablet whole with liquid and avoid cutting, crushing, or chewing it.
Does Veozah Work to Reduce Hot Flashes?
Veozah reduces the number and severity of hot flashes, day and night.
While individual results vary, many patients get relief within a week or so.
Here are the clinical trial results:
At 12 weeks, women taking Veozah experienced 63 percent fewer hot flashes than 42 percent taking a placebo.
Very good results, although the placebo results are pretty good, too.
Does Veozah Have Side Effects?
Veozah sometimes causes serious side effects, including increases in liver blood test values.
Your healthcare provider should perform a blood test to check your liver before you start Veozah. The test is repeated at months 3, 6, and 9 after you start the medicine.
Please call your healthcare provider immediately if you have symptoms suggestive of liver problems, including:
- nausea or vomiting
- yellowing of the skin or eyes
- upper right abdominal pain.
Veozah — Common Side Effects
The most common toxicities of Veozah include:
- abdominal pain
- diarrhea
- insomnia
- back pain
- hot flashes
Of course, these are not all of the potential side effects.
Please notify your healthcare provider if you have any toxicity that bothers you or does not go away.
Who Should Not Use Veozah?
You should not use Veozah if:
- You have liver cirrhosis.
- You have severe kidney problems or kidney failure.
- You are taking certain medicines called CYP1A2 inhibitors. Ask your healthcare provider if you are not sure.
Cost
One of my patients recently informed me that Veozah not all health insurers in the U.S. pay for the drug.
The drug may be and may be prohibitively expensive for many people, as it costs about $550 per month.
I think U.S. insurers will eventually pay for the drug.
Summary
As someone involved in the care of scores of women with cancer, I know that vasomotor symptoms such as hot flashes and night sweats are very significant for some.
I love that these women who can’t — my patients with hormone-driven breast cancer are an example — or won’t use hormone therapy (the most common and effective treatment) have a new option.
Do you suffer from vasomotor symptoms such as hot flashes or night sweats?
If yes, what strategies have been effective for you?
