The first brand-new hot flash medications could be available in 2023, after 80 years.


With the introduction of Premarin in 1941, menopausal women were finally able to experience a reduction in hot flashes. The estrogen-based hormonal medication helps to balance hot flashes and other menopause symptoms by reintroducing a portion of the body's natural estrogen. Additionally, since 1941, no additional medication classes have been accessible for the same use.

The following year, that can alter. A new non-hormonal medication designed exclusively for hot flashes might be made available as early as 2023, according to Meryl Davids Landau of National Geographic earlier this month. Currently, the Food and Drug Administration is evaluating the drug fezolinetant.

Around 80% of women who are going through menopause experience hot flashes; some people have more than seven episodes per day. From a few seconds to several minutes, there are flashes. A very unfortunate third of menopausal women must endure regular hot flashes for upwards of ten years. On average, hot flashes last about four years for menopausal women. It's considerably worse for American women who are Black or Native. Their flashes are more frequent, start earlier, and last longer.

Scientists didn't fully understand the origin of hot flashes until recently. They were aware that a dysfunctional hypothalamus was a contributing factor, but they were unsure of the particular source of the issue. However, a 2018 study published in the journal Neuroendocrinology demonstrates that it was finally possible for researchers to pinpoint it to certain KNDy (pronounced candy) neurons in the hypothalamus. The new medication stops the KNDy neurons that control temperature when they begin to respond inappropriately, which results in a hot flash.

In her keynote address at the 2020 Annual North American Menopause Society Conference, Dr. Susan Reed noted, "When estrogen falls, it triggers this KNDy neuron complex to really literally go wild." "It's like turning on a ton of fire hydrants, which flood the nearby thermoregulatory center and disrupt it, resulting in hot flashes. The thermoregulator center communicates with the rest of the body to warm us when we are too cold (shiver) or cool us when we are too hot (hot flashes).

According to early findings from phase three clinical trials, fezolinetant removes two to four heat flashes per day. In phase three studies is a different medication called elinzanetant, which functions similarly. Given that two-thirds of working women (in the UK alone) report that menopause symptoms have a negative influence on their workplace, these drugs may become in high demand.

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