The first non-hormonal treatment for the menopause has now been approved in Scotland

Good news for women who cannot take hormone replacement therapy (HRT). Scotland has approved fezolinant (Veoza) – the first non-hormonal treatment designed to manage hot flushes and night sweats during the menopause.

How does it work?

Unlike HRT, fezolinetant does not contain any hormones. It acts directly on the brain’s thermoregulatory centre by blocking the signals that trigger hot flushes.

What do the studies show?

Large-scale clinical trials show that the medicine:

• significantly reduces the frequency of heatwaves;
• reduces their strength;
• improves the quality of life for women for whom HRT is not suitable.

The medicine is approved for women for whom hormone therapy is not suitable or is contraindicated.

Like any medicine, this one also has potential side effects. The most commonly reported side effects are headaches, nausea, tiredness and upper respiratory tract infections.

As it may, in rare cases, affect liver function, it is recommended that liver enzyme levels be monitored before starting treatment and during the course of treatment.

Menopause and nutrition

Medication is just one of the possible approaches to managing the symptoms of the menopause. Diet and lifestyle can also play an important part in looking after your health during this time.

If you’d like to find out more, do have a read of our article Menopause and nutrition, in which we look at how diet can support the body during the menopause.

Dosing, safety and monitoring

The recommended dose is 45 mg once daily, taken by mouth.

According to the manufacturer, around 48,600 women will be eligible for treatment as early as the first year, with this figure potentially rising to over 50,000 by the fifth year.

Clinical trials show that the medicine is generally well tolerated. Adverse reactions observed in more than 5% of participants include:

• headache;
• upper respiratory tract infections;
• nausea;
• fatigue;
• nasopharyngitis;
• elevated blood sugar levels.

Elevated liver enzyme levels have also been observed during treatment. Therefore, fezolinetant must not be used in patients with known liver disease or at high risk of developing such a condition.

It is recommended that liver function be assessed before starting treatment and periodically during therapy, and that regular assessments be carried out to determine whether the benefits of treatment continue to outweigh the risks, as the duration of menopausal symptoms varies from woman to woman.

A new opportunity for women going through the menopause

This is an important step towards providing more options for personalised treatment of the symptoms of the menopause, particularly for women who are unable to use hormone therapy.