Novel nonhormonal treatments for vasomotor symptoms of menopause.

Purpose of review: Hot flashes are a prevalent and bothersome symptom associated with menopause. Beyond the fact that they cause discomfort, hot flashes are responsible for significant healthcare costs and lost productivity among midlife women. They may also be a harbinger for future disease risk. While hormone therapy is a mainstay of treatment, many women cannot or do not wish to take hormones to mitigate their hot flashes.

Recent findings: The discovery of the linkage of the neurokinin (NK) receptor to hot flashes has resulted in a rapid bench-to-bedside development of a new class of compounds targeting the NK3 receptor and its related pathways. Fezolinetant is the first FDA-approved medication in this class, and elinzanetant is awaiting FDA approval. Both agents are effective against hot flashes and represent exciting new nonhormonal treatments that are free of untoward off-target effects. Both have demonstrated improvements in patient self-reported sleep outcomes.

Summary: Targeting of the NK receptor in the hypothalamus has led to the availability of nonhormonal options for menopausal women suffering from hot flashes.