New Therapies for Menopausal Hot Flashes Complaints

Hot flashes are one of the most common menopausal symptoms women experience in middle age, and many menopausal women are bothered by these symptoms. Hot flashes, also known as a vasomotor symptom, are the most common menopausal symptom experienced by three out of four women. Emphasis was placed on promising treatments for vasomotor symptom at the 2021 meeting of the North American Menopause Society.

Symptoms Like Hot Flashes Can Last For Many Years

According to the North American Menopause Society, it can take an average of 7 to 10 years for women to experience during menopause, along with other menopausal symptoms, including hot flashes, night sweats, and mood swings. Sometimes even these symptoms can last even longer for women who started perimenopause. According to Kristi Tough DeSapri, an assistant professor at Northwestern University, it’s common for women to reach menopause and think they’ll get rid of symptoms once their period ends, but unfortunately that’s not the case. However, it is now known that there is no definite deadline for when the symptoms will subside.

New Treatments for Hot Flashes Complaints

Various treatments are currently under investigation for vasomotor symptom management. In a presentation at the NAMS Annual Meeting in Washington, DC, September 22-25, 2021, Dr. Faubion highlighted several promising treatments, some of which have already been approved for other conditions. These treatment methods include treatments that are new compounds that have not yet been approved by the US Food and Drug Administration (FDA). Here are study summaries of some of the newer treatment options;


Experts note that oxybutynin, an older drug used for overactive bladder, has recently been shown to successfully reduce hot flashes. By looking at a 2019 study of oxybutynin for hot flashes, and researchers found that it reduced hot flashes by roughly 77 percent in studies and was very effective.

But the concern with this drug is that it is an anticholinergic, a class of drugs that in some studies has been linked to an increased risk of dementia when used long-term in older people. Although this population has other comorbidities, causation is difficult to establish. It is stated that it is unclear whether the use of this drug for menopausal symptoms for several years in middle age will have any adverse effects.

Estetrol (E4)

Estetrol is a naturally occurring estrogen that has been shown in early studies to reduce the frequency and severity of hot flashes, as well as improve the vaginal maturation index. This index measures how much estrogen is found in the vaginal epithelium (inner lining) as well as in the vulva, urethra, and bladder, and is used to evaluate what treatments would be helpful for treating vaginal hormonal symptoms such as vaginal dryness.

The estrogen produced in the ovaries during the reproductive years is E2, called estradiol. Estetrol’s first drug containing the E4 hormone was approved this year and is marketed as the oral contraceptive Nextstellis. The same company is currently conducting phase 3 trials of this therapy in postmenopausal women who want to use it.

The plan of this pharmaceutical company is to assist women of reproductive age with postmenopausal hormone therapy, when needed, with this estrogen-containing drug version during the menopausal transition. More information is needed about this therapy, including its long-term efficacy and safety. However, early studies show that it is effective in reducing the frequency and severity of hot flashes and also treats vaginal dryness.

It is still unclear when any of these new treatments will become available or approved for menopausal symptoms. And its process is difficult to predict.

Personal Factors When Managing Menopause Symptoms

Personal factors are important in determining the appropriate treatment when managing menopausal symptoms. While increasing the success rate of this treatment, it can also help to get results in a shorter time. These factors are as follows;

• What are the bothersome menopause symptoms?

• What is a health history such as breast cancer or osteoporosis?

• Does the individual have children?

• Did she experience pregnancy poisoning during pregnancy?

• Smoker?

• What is the activity level?

There is no single “right answer” when it comes to choosing the appropriate treatment for menopausal symptoms, and this is another reason to be excited about having additional treatment options. It has been found from observational studies that in women with bothersome menopausal symptoms, if they have experienced menopause within the past 10 years and are younger than 60, the benefits of treatment outweigh the risks in most cases.


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