For many women hot flushes and night sweats are among the most disruptive symptoms of menopause. They can interrupt sleep, affect concentration, reduce confidence and have a significant impact on everyday life. While Hormone Replacement Therapy (HRT) remains the gold standard treatment for menopause symptoms it isn’t suitable for everyone.
That’s why the recent approval of Fezolinetant (Veoza) for NHS use is such welcome news. Following guidance from NICE the medication is now available for women with moderate to severe hot flushes and night sweats in circumstances where HRT is unsuitable offering hope to hundreds of thousands of women who previously had limited treatment options. Around 500,000 women in England are expected to be eligible for the new treatment. (NICE)
How does it work?
Unlike HRT, Fezolinetant contains no hormones. Instead, it targets the brain’s temperature regulation centre. During menopause falling oestrogen levels can make this system over-sensitive, causing the body to trigger hot flushes even when there is no real change in temperature. Fezolinetant blocks specific nerve signals involved in this process which helps to reduce both the frequency and intensity of hot flushes and night sweats. (NICE)
Who could benefit?
Fezolinetant has been approved for women whose hot flushes and night sweats are having a significant impact on their daily lives when HRT isn’t appropriate. This may include women who:
- Have medical reasons why HRT isn’t recommended.
- Have experienced blood clots such as deep vein thrombosis (DVT) or pulmonary embolism.
- May have certain heart conditions or diabetes following specialist assessment.
- Prefer not to take hormone-based treatments.
Your healthcare professional will discuss whether this medication is suitable for your individual circumstances. (NICE)
Is it a replacement for HRT?
No. HRT remains the recommended first-line treatment for most women because it addresses the underlying hormonal changes of menopause and can improve many symptoms beyond hot flushes, including vaginal symptoms, joint aches and helping to protect bone health.
Fezolinetant is designed specifically to treat vasomotor symptom – hot flushes and night sweats. It does not replace oestrogen and is not intended to treat all menopausal symptoms. (British Menopause Society)
What else should women know?
Like any medication, Fezolinetant isn’t suitable for everyone. Liver function tests are needed before starting treatment and during the first few months to ensure it is being used safely. Your GP or menopause specialist will explain the monitoring required if this treatment is recommended for you. (NICE)
A Positive Step Forward
The approval of Fezolinetant represents an important milestone in menopause care. For years, women who couldn’t take HRT have often had limited options for managing severe hot flushes and night sweats. Having a new evidence-based, non-hormonal treatment available on the NHS offers greater choice and recognises that menopause care should never be “one size fits all.”
As always, the best treatment is the one that’s right for you. If your menopause symptoms are affecting your quality of life, speak to your GP or menopause specialist about the options available and together you can decide on the approach that best meets your individual needs.
