Menopause Connect
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2yr
Novel MOA targets age-old condition

Hot flashes—experienced by 70%-80% of menopausal women—are physically distressing and worsen quality of life. Newer therapies, such as NK3R antagonists, leverage a non-hormonal approach to addressing these symptoms.

For example, fezolinetant is a selective NK3R antagonist that directly blocks NKB from binding to the KNDy neuron. NKB is a known trigger of vasomotor symptoms (VMS).

KNDy neurons located at the level of the hypothalamus are inhibited by estrogen and triggered by the neuropeptide NKB, thus resulting in the regulation of body temperature.

During menopause, estrogen decline interferes with this balance involving NKB. Left unopposed, NKB signaling increases KNDy neuronal activity. This process sets off heat-dissipation mechanisms, such as vasodilation and sweating (or VMS).

Thus, fezolinetant helps decrease the frequency and intensity of hot flashes and night sweats, honing in on NK3R with an affinity 450 times higher than that of NK1 or NK2 receptors.

What are your thoughts on this new mechanism of action for the treatment of VMS?

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  • 2yr
    Nice addition to treatment options for VMS. Plan to check on formulary coverage.
  • 2yr
    Great to have another tool in the toolkit

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Bone Health in Women With Premature Ovarian Insufficiency/Early Menopause: a 23-Year Longitudinal Analysis

Source : https://academic.oup.com/humrep/advance-article/doi/10.1093/humrep/deae037/7613529?login=false

In this 23-year longitudinal study, by the age of 68 years, one-half of women with premature ovarian insufficiency/early menopause developed osteoporosis or a fracture.

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Menopause and the Role of Physical Activity - the Views and Knowledge of Women Aged 40-65

Menopause and the Role of Physical Activity - the Views and Knowledge of Women Aged 40-65

Source : https://pubmed.ncbi.nlm.nih.gov/38393976/

Menopause marks the end of female reproductive capacity. It is defined as the point after cessation of the menstrual cycle for 12 months (Nursat et al., 2008). Awareness about menopause...

This study found that women’s knowledge was not in line with their perceptions, perhaps in part due to where they are obtaining information.

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Treating Hot Flashes With Hypnosis: Does Hypnotizability Modulate Reductions?

Treating Hot Flashes With Hypnosis: Does Hypnotizability Modulate Reductions?

Source : https://pubmed.ncbi.nlm.nih.gov/38265698

Hypnosis is an effective treatment option for a variety of concerns. Past research has suggested that those who score in the high range of hypnotizability initially show greater improvement than...

Participants who were rated as either moderately or highly hypnotizable achieved a 50% reduction by Week 3 while those of low hypnotizability did not cross the 50% reduction threshold until the 12-week follow-up.

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The impact of 17β-Estradiol on the Estrogen-Deficient Female Brain: From Mechanisms to Therapy With Hot Flushes as Target Symptoms

The impact of 17β-Estradiol on the Estrogen-Deficient Female Brain: From Mechanisms to Therapy With Hot Flushes as Target Symptoms

Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10800853/

Sex steroids are essential for whole body development and functions. Among these steroids, 17β-estradiol (E2) has been known as the principal "female" hormone. However, E2's actions are not restricted to...

A noninvasive DHED prodrug approach may offer a translational value in terms of defining a therapeutic landscape to remedy the E2-deficient brain safely and efficaciously, including the alleviation or prevention of VMS.

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Obesity and Menopause

Obesity and Menopause

Source : https://pubmed.ncbi.nlm.nih.gov/38343134/

Obesity is not a choice or a result of lack of willpower, but a multifactorial, chronic, progressive, and relapsing disease. During menopause, hormonal and body composition changes lead to greater...

The use of estrogen-only or combined transdermal MHT does not increase the risk of thrombotic events in women with obesity.

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Passive Exercise Is an Effective Alternative to HRT for Restoring OVX Induced Mitochondrial Dysfunction in Skeletal Muscle

Passive Exercise Is an Effective Alternative to HRT for Restoring OVX Induced Mitochondrial Dysfunction in Skeletal Muscle

Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10864566/

Postmenopausal women are more prone to develop muscle weakness, which is strongly associated with impairment of mitochondrial function in skeletal muscle. This study aimed to examine the impact of a...

Whole-body vibration training exhibits the ability to not only restore muscle weakness and mitochondrial dysfunction resulting from reduced estrogen levels but also to augment mitochondrial biogenesis.

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Safety and Efficacy of a Class II Medical Device Based on Highly Purified and Standardized Plant Extracts in the Management of Post-Menopausal Patients With Vulvar and Vaginal Atrophy: a Single-Center Prospective Observational Study

Safety and Efficacy of a Class II Medical Device Based on Highly Purified and Standardized Plant Extracts in the Management of Post-Menopausal Patients With Vulvar and Vaginal Atrophy: a Single-Center Prospective Observational Study

Source : https://pubmed.ncbi.nlm.nih.gov/38358384/

In women with GSM, the intravaginal administration of a hyaluronate-based gel enriched with purified botanical actives endowed with anti-inflammatory and mucosal-protecting properties, reduced painful sensation during sexual acts and increased...

In women with genitourinary syndrome of menopause, the intravaginal administration of a hyaluronate-based gel enriched with purified botanical actives endowed with anti-inflammatory and mucosal-protecting properties, reduced painful sensation during sexual acts and increased regular sexual activity.

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A Systematic Review and Critical Appraisal of Menopause Guidelines

A Systematic Review and Critical Appraisal of Menopause Guidelines

Source : https://srh.bmj.com/content/early/2024/02/09/bmjsrh-2023-202099.long

To identify and appraise current national and international clinical menopause guidance documents, and to extract and compare the recommendations of the most robust examples.

The highest quality clinical practice guidelines consistently recommended menopausal hormone therapy for vasomotor symptoms and menopause-associated mood disturbance.

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2yr
Does a Program-Based Cognitive Behavioral Therapy Affect Insomnia and Depression in Menopausal Women? A Randomized Controlled Trial

Does a Program-Based Cognitive Behavioral Therapy Affect Insomnia and Depression in Menopausal Women? A Randomized Controlled Trial

Source : https://pubmed.ncbi.nlm.nih.gov/38329153/

ClinicalTrials.gov Identifier: NCT05920460.

Significant improvements were observed between pre- and postinterventions in the study group for the total scores on the Insomnia Severity Index, Pittsburgh Sleep Quality Index, and Beck Depression Inventory, 2nd ed.

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2yr
Incidence and Risk Factors of Stress Urinary Incontinence After Laparoscopic Hysterectomy

Incidence and Risk Factors of Stress Urinary Incontinence After Laparoscopic Hysterectomy

Source : https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-024-02942-2

To observe the long-term effects of total hysterectomy on urinary function, evaluate the effects of preoperative nutritional status, urinary occult infection, and surgical factors on the induction of postoperative stress...

Menopause, preoperative hemoglobin ≤100 g/L, preoperative urine bacteria ≥ 100 u/L, uterine volume ≥90 cm3, history of chronic cough, and BMI ≥28 kg/m2 were risk factors for postoperative stress urinary incontinence in patients undergoing hysterectomy.

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Advancing the Inclusion of Black Women in Studies of Menopause

Advancing the Inclusion of Black Women in Studies of Menopause

Source : https://academic.oup.com/biomedgerontology/article/79/2/glad284/7592002?login=false

The climacteric phase of a woman's life is marked by a natural transition in reproductive function. While there is variation in women's menopausal experiences,

In this letter, authors discussed the how addressing the menopausal health challenges faced by Black women requires a change in recognition and acceptance of generalizations of menopause.

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2yr
An Ethical Assessment of Compounded Bioidentical Hormone Therapy

An Ethical Assessment of Compounded Bioidentical Hormone Therapy

Source : https://pubmed.ncbi.nlm.nih.gov/38288691/

The use of compounded bioidentical hormone therapy (cBHT) continues to grow in popularity despite the availability of many US Food and Drug Administration-approved hormone products produced in different formulations and...

The study authors commented that promoting and prescribing cBHT as first-line therapy violates a number of ethical tenets of medical and pharmacy practice and should be discouraged without a compelling reason.

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The Benefits and Risks of Menopause Hormone Therapy for the Cardiovascular System in Postmenopausal Women: a Systematic Review and Meta-Analysis

The Benefits and Risks of Menopause Hormone Therapy for the Cardiovascular System in Postmenopausal Women: a Systematic Review and Meta-Analysis

Source : https://bmcwomenshealth.biomedcentral.com/articles/10.1186/s12905-023-02788-0

Menopause hormone therapy (MHT), as an effective method to alleviate the menopause-related symptoms of women, its benefits, risks, and potential influencing factors for the cardiovascular system of postmenopausal women are...

Menopause hormone therapy can improve flow-mediated arterial dilation in the overall population of postmenopausal women, but it fails to lower the risk of all-cause death and cardiovascular events.

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The Effect of Music on Menopausal Symptoms, Sleep Quality, and Depression: a Randomized Controlled Trial

The Effect of Music on Menopausal Symptoms, Sleep Quality, and Depression: a Randomized Controlled Trial

Source : https://pubmed.ncbi.nlm.nih.gov/38265351/

This study shows that music may have an effect on reducing the level of menopausal symptoms and depression levels and also increasing the sleep quality of menopausal women.

The post-test Menopausal Symptoms Rating Scale, Beck Depression Inventory, and Pittsburg Sleep Quality Index scores of the menopausal women were found to be lower in women who listened to music twice a day for 5 weeks than in the control group.

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Skin Rejuvenation in Women Using Menopausal Hormone Therapy: a Systematic Review and Meta-Analysis

Skin Rejuvenation in Women Using Menopausal Hormone Therapy: a Systematic Review and Meta-Analysis

Source : https://pubmed.ncbi.nlm.nih.gov/38230593/

MHT increases elasticity and collagen content in the skin, thereby reducing the severity of wrinkles and increasing skin thickness. Nevertheless, more well-conducted clinical trials are required to answer all questions...

Menopausal hormone therapy increased elasticity and collagen content in the skin, thereby reducing the severity of wrinkles and increasing skin thickness.

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Hormonal and Reproductive Factors in Relation to the Risk of Rheumatoid Arthritis in Women: a Prospective Cohort Study With 223,526 Participants

Hormonal and Reproductive Factors in Relation to the Risk of Rheumatoid Arthritis in Women: a Prospective Cohort Study With 223,526 Participants

Source : https://rmdopen.bmj.com/content/10/1/e003338.long

This study aimed to examine rheumatoid arthritis (RA) risk associated with hormonal and reproductive factors in women from the large cohort of the UK Biobank. Data on hormonal and reproductive...

Hormone replacement therapy and its duration of use were both associated with a higher risk of rheumatoid arthritis.

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Genitourinary Syndrome of Menopause in Cancer Survivors

Genitourinary Syndrome of Menopause in Cancer Survivors

Source : https://journals.lww.com/clinicalobgyn/abstract/9900/genitourinary_syndrome_of_menopause_in_cancer.128.aspx

In this review, we cover important considerations in the assessment of GSM; nonpharmacologic, behavioral, integrative, pharmacologic, and medical device treatments for GSM: the unique considerations in GSM by cancer treatment...

The number of cancer survivors is increasing, and the unique aspects of management of genitourinary syndrome for cancer survivors, such as the safety of hormonal therapies, is important to understand.

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Fezolinetant: a Potential Treatment for Moderate to Severe Vasomotor Symptoms of Menopause

Fezolinetant: a Potential Treatment for Moderate to Severe Vasomotor Symptoms of Menopause

Source : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10769482/

The most common symptom of menopause is vasomotor symptoms (VMS), which occur in more than 80% of postmenopausal women. Furthermore, VMS are the manifestation of menopause for which women most...

As early as 4 weeks from initiating fezolinetant, women experienced a statistically significant reduction of both severity and frequency of VMS per day.

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The Association of Menopause With Cardiometabolic Disease Risk Factors in Low- and Middle-Income Countries: a Systematic Review and Meta-Analyses

The Association of Menopause With Cardiometabolic Disease Risk Factors in Low- and Middle-Income Countries: a Systematic Review and Meta-Analyses

Source : https://journals.lww.com/menopausejournal/abstract/2024/01000/the_association_of_menopause_with_cardiometabolic.12.aspx

This study aimed to evaluate evidence from the literature on differences in CMD risk factors between premenopausal and postmenopausal midlife women living in low- and middle-income countries.

Compared with premenopausal women, the postmenopausal stage was associated with metabolic syndrome, high waist-to-hip ratio, hypertension, elevated triglycerides, and elevated plasma glucose.

 

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