70-80% of women suffer from it, they can last for many years and often impact quality of life and sometimes mental health. These are hot flashes, typical symptoms of menopause which, however, can occur even earlier, in the transition phase leading to the end of the menstrual cycle. The most effective remedy, to combat all other symptoms, remains hormone therapy, which however some women cannot follow. This is why new, non-hormonal drugs are on the way, which promise to be very effective. This was discussed in Cleveland, at the North American menopause society (NAMS) convention.
What are hot flashes
“It is a disturbance of the body’s thermoregulatory mechanism, influenced by sex hormones. When they fail, as in the case of menopause, there is an alteration that leads to an imbalance in temperature control. It is therefore easy to feel a warmth. sudden, having a strong sweating and, subsequently, shivering to compensate – he explains Angelo Cagnaccigynecologist, director of the obstetrics and gynecology department of the San Martino hospital in Genoa and president of the Italian Menopause Society – Most women suffer from it and can last up to 10-12 years, but intensity and frequency tend to decrease with time”.
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Heart health
At the Cleveland congress it was pointed out that more and more studies have now ascertained that hot flashes are not just a passing annoyance but can affect heart health. “The more intense and frequent they are, the more those who suffer from it are at risk not only of having cardiovascular disease but also of developing other risk factors such as high blood pressure and blood sugar, low HDL, atherosclerosis and osteoporosis – concludes the gynecologist -. Four-five hot flashes – concludes the gynecologist -. per day they can fall within the norm, but if the number reaches 10-15 and they occur above all at night, affecting the quality of sleep, the advice is to immediately contact the specialist for adequate treatment “.
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New remedies on the way
But how are hot flashes treated? “It is estimated that 25% of women adopt a drug remedy for the treatment of vasomotor symptoms – she explains Susan Reed, of the University of Washington School of Medicine, present at the Cleveland congress -. Today we have pills, patches and gels available, but there have been no new drugs in the past decade. Instead we hope to see a change of pace in the next two years, when molecules will hit the market. ”
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Also being tested in Italy
He was researching it ahead and new drugs will soon arrive on the market. “Those of the latest generation are neurokinin 3 antagonist drugs and block the receptor of this polypeptide (which acts as a neurotransmitter), in order to moderate neuronal activity in the thermoregulatory center of the brain and reduce the frequency and severity of hot flashes. . We know in fact that excess heat is associated with an excessive production of neurokinin – explains Cagnacci -. By acting on the final thermoregulation system and not on individual transmitters like the drugs we already have, they should be much more effective “.
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In the United States, the FDA, the regulatory body for the drug, is considering the approval of two molecules, fezolinetant and elinzanetant. A third, pavinetant, was abandoned due to liver side effects. At San Martino di Genova the fezolinetant is already in phase three of experimentation among a group of volunteers who have had a tumor and within 1-2 years it could arrive in pharmacies. The results are very encouraging, according to the specialist. Being a non-hormonal remedy it could be prescribed to all women.
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The treatments already available
In addition to hormone therapy, by far the most effective, drugs are currently available that act on the central nervous system, which influences thermoregulation, and act on serotonin (they are mainly used as antidepressants). There are also those who rely on herbal medicine with extracts of soy, black cohosh and pollen. “All these remedies improve the symptoms and balance the changes but do not completely eliminate the disorder.”
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