While hormone therapy (HT) is the most effective way to tackle many menopause symptoms, it isn’t suitable for everyone. Some people can’t take HT for medical reasons while others prefer not to. There are other options. Fezolinetant, sold under the brand name Veozah, is the latest non-hormonal menopause treatment for hot flashes and night sweats. Read on to find out if it could help you and the evidence behind this new treatment.
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What is this new non-hormonal treatment?
Fezolinetant is currently sold under the brand name Veozah. It belongs to a new group of medicines called NK3R antagonists. These can be used to treat vasomotor menopause symptoms such as hot flashes and night sweats.
Menopause symptoms are caused by unstable and declining levels of estrogen during and after menopause. We use HT to treat these symptoms by supplying the body with the estrogen it no longer produces.
This is a simple and effective approach, but it isn’t the only way to treat menopause symptoms.
Over recent years, more attention has been paid to the way menopause affects part of the brain called the hypothalamus. The hypothalamus contains the body’s ‘thermostat’, and changing hormone levels at menopause can cause the thermostat to be too sensitive to small increases in body temperature. This is why hot flashes and night sweats are annoyingly common at this time.
But it seems that it isn’t just estrogen that plays a part – other chemicals are partly responsible. Neurokinin B is one example. It is thought to act more powerfully on the hypothalamic thermostat in response to falling estrogen levels. This causes issues with temperature control, which can lead to hot flashes and night sweats.
NK3R antagonists prevent neurokinin B from binding to its receptors, which blocks some of its actions and reduces the frequency and severity of those infuriating hot flashes.
Why are people excited about this new non-hormonal treatment?
We know that HT is a highly effective treatment for menopause symptoms, but it comes with certain risks. These depend on your medical history and health, but can include an increased risk of breast cancer and blood clots. This is why HT is not suitable for everyone.
Fezolinetant – also known as Veozah – is hormone-free. This makes it an exciting new product for the treatment of menopause symptoms. It gives an alternative option if you need effective treatment but cannot or prefer not to take hormones.
What is the evidence?
Evidence is still emerging about the safety and effectiveness of NK3R antagonists like fezolinetant, but there is enough evidence that the US Food and Drug Administration (FDA) has approved it for doctors to prescribe. Another drug in the same class called elinzanetant is pending FDA approval at this time.
Studies seem to show that fezolinetant works very quickly, with some studies finding a beneficial effect on both hot flashes and night sweats within just a few days.
However, because it is new, there is still not much information about the long-term effects of fezolinetant.
How can I get fezolinetant?
Fezolinetant, sold under the brand name Veozah, was made available in the US in May 2023. The cost for fezolinetant is a whopping $550 for a 30-day supply.
Fezolinetant isn’t suitable for everyone. It is not recommended for people with some types of liver disease or severe kidney disease. It will also not help menopause symptoms other than hot flashes, so you may still struggle with other issues.
Learn more about the different types of HT.
How do I take fezolinetant?
Fezolinetant, sold as Veozah, comes as a 45mg tablet. The dose is one tablet per day.
What other non-hormonal treatment options are available for menopause symptoms?
Fezolinetant is the most recently approved non-hormonal treatment option for menopause symptoms, but several others are widely used. Although HT is generally more effective, non-hormonal treatments could be a good option if you are unable to take hormones or just aren’t keen on the idea.
Certain types of antidepressants are sometimes used to improve menopause symptoms, including hot flashes. These include common medications like paroxetine, sertraline and citalopram
There are a number of other FDA-approved medications that were not originally designed to reduce hot flashes and night sweats, but were later found to be effective. Examples include gabapentin and oxybutynin
Finally, lifestyle changes can be effective too. Caffeine, alcohol, smoking, stress, and lack of exercise can all have an impact on symptoms including hot flashes and night sweats.
Final word
Fezolinetant may be a good option for you if you are unable or prefer not to take HT. However, it is still very expensive and only works for hot flashes and night sweats, so you might still struggle with other menopause symptoms.
Find out more about menopause on our blog or in our symptoms library.
- Busting common myths about HT
- Anderson RA, Skorupskaite K, Sassarini J. 2019 The neurokinin B pathway in the treatment of menopausal hot flushes. Climacteric, vol 22, No. 1, pp. 51-54.
- Lederman, Samuel MD; Shapiro CM, Marla MD; Stute, Petra MD; Lee, Misun PhD; Wang, Xuegong PhD; Neal-Perry, Genevieve PhD. 2022, May Phase 3 Study of Fezolinetant for Treatment of Moderate-to-Severe Vasomotor Symptoms Associated With Menopause [A132]. Obstetrics & Gynecology, vol 139(): p. 39S
- Menown SJ, Tello JA. 2021, Oct Neurokinin 3 Receptor Antagonists Compared With Serotonin Norepinephrine Reuptake Inhibitors for Non-Hormonal Treatment of Menopausal Hot Flushes: A Systematic Qualitative Review. Adv Ther, vol 38(10), pp 5025-5045.
- Prague JK, Roberts RE, Comninos AN, Clarke S, Jayasena CN, Nash Z, Doyle C, Papadopoulou DA, Bloom SR, Mohideen P, Panay N, Hunter MS, Veldhuis JD, Webber LC, Huson L, Dhillo WS. 2017, May Neurokinin 3 receptor antagonism as a novel treatment for menopausal hot flushes: a phase 2, randomised, double-blind, placebo-controlled trial. Lancet, vol 389, Issue 10081, pp1809-1820.
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