Advances in nonhormone therapies provide women with more options for managing hot flashes
Although many women manage menopause symptoms with hormone therapy, increasing numbers of women are considering nonhormone options. Dr. Susan Reed from the University of Washington School of Medicine is a featured speaker during the 2020 Pre-Meeting Symposium of The North American Menopause Society (NAMS) and will discuss the latest advances in nonhormone hot flash management. One of the more promising drug developments targets the KNDy neuron complex.
According to Dr. Reed, who serves as the vice chair of the Department of Obstetrics and Gynecology at the University of Washington School of Medicine in Seattle, successful nonhormone therapies that preceded work in the area of kisspeptin, neurokinin B, and dynorphin (KNDy) neuron targeting include selective serotonin reuptake inhibitors (SSRIs), serotonin-norepinephrine reuptake inhibitors (SNRIs), gabapentin, oxybutynin, and clonidine. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors given in higher doses are primarily used for depression management. GABAergic drugs, such as gabapentin and pregabalin, are currently used for pain syndromes and seizures. Oxybutynin is FDA approved for overactive bladder. New research focused on a better understanding of the physiology of menopause hot flashes is leading to the development of new nonhormone pharmacotherapies.
In her presentation during the 2020 Pre-Meeting Symposium, Dr. Reed will summarize progress on drug development targeting the KNDy neuron complex, adverse effects of these novel drugs, and their long-term potential as nonhormone therapies for menopause symptoms.
"At menopause, diminished estrogen causes the KNDy neurons to go into hyperdrive, activating the adjacent thermoregulatory center, resulting in hot flashes," explains Dr. Reed. "To date, there are no FDA-approved products for menopause directed toward the KNDy neuron complex, but drugs first developed for pain control and for mood disorders acting via KNDy are under investigation for the treatment of vasomotor symptoms in the United States and Europe and hold great promise."
Beyond her discussion on the future of these new treatments, Dr. Reed will also present new data on the effectiveness of oxybutynin, as well as existing data on SSRIs/SNRIs, GABAergics, and clonidine.
"Hot flashes are one of the most common complaints of postmenopausal women, adversely affecting their overall quality of life," says Dr. Stephanie Faubion, NAMS medical director. "Although hormone therapy remains one of the most-proven methods of treatment, some women are unwilling or unable to take hormones. That's why this presentation on the latest innovations in the nonhormone treatment options for hot flashes is so valuable."
Drs. Reed and Faubion are available for interviews before the presentation during the virtual annual meeting which starts on September 28.