New evidence shows glowing results for a menopause medication that avoids the risks associated with traditional hormone therapy.
“The magnitude of the effect was interesting,” senior author Dr. Pauline M. Maki told The Post. “I didn’t anticipate it, though, because it’s a hard level of symptoms to improve.”
The study showed that fezolinetant, sold under the brand name Veozah, significantly improved hot flashes, including night sweats, after 4 weeks. Both the number and intensity of hot flashes decreased.
Depression and anxiety symptoms also significantly improved as early as 4 weeks. Before taking the medication, participants exhibited mild symptoms, including loss of interest, difficulty doing daily activities, and feeling anxious. On medication, symptoms went from mild to normal.
These results echo the positive effects found in clinical trials, but still offer a new perspective. This study was the first to examine the medicine’s effects on real-world women going through menopause.
Clinical trials generally have restrictive criteria for study enrollment, which means their participants are usually healthier than the general population, said of the University of Illinois Chicago College of Medicine.
In a study like this one, we can observe the effects on a population of women more representative of the real world.
“You get the kind of people like me, [like] anybody who walks into their doctor’s office and is seeking help for their hot flashes,” Maki said. “It’s a pertains to a broader segment of the population. So when you can replicate both the magnitude of the benefit and the timing of the benefit in the real world, it’s quite reassuring to women.”
How menopause affects women
Menopause comes with an array of physical and emotional symptoms. Over 8 in 10 menopausal women get hot flashes, and continue having them for seven to 11 years. When they happen at night, it can chronically disturb sleep, causing secondary problems.
Starting in perimenopause, women’s ovaries start producing less estrogen and progesterone. Research suggests that decreased estrogen causes the hypothalamus, the body’s thermostat, to become hyper reactive to changes in temperature.
As many as 50% of perimenopausal and menopausal women experience psychological and emotional symptoms, including anxiety, depression, insomnia, and forgetfulness.
Lowered estrogen is linked to lowered levels of serotonin, a “happy hormone” which regulates mood, and heightened cortisol, a stress hormone.
What menopause treatments are available?
Hormone therapy is considered the gold standard for hot flashes, Maki said, in part because it’s been around the longest. Supplemental estrogen usually administered in pills, skin patches, gels and sprays.
For over 20 years, estrogen treatments were associated with risk of cancer and other serious conditions. Recent research has shown this is not the case, leading the FDA to eliminate warnings in November.
Still, women may want to avoid hormone therapy for other reasons. Taking hormones like estrogen affects everyone differently, but can cause moodiness, weight gain, headaches and decreased libido.
There are also certain populations that can’t take HRT, including those with certain types of cancer, people with uterine bleeding, or those at risk of blood clots.
There are two main non-hormonal menopause treatments for hot flashes. One is the subject of this study, fezolinetant, which was approved by the FDA in 2023. The other is elinzanetant, sold under the brand name Lynkuet, which was approved in October 2025.
“Whatever drug is approved first generally has the ability to study its effects in the real world first, and
fezolinetant was approved first,” Maki said. “So yes, we have more real world data on fezolinetant. And though similar studies are certainly underway with elinzanetant.”
While hormone therapy works by replacing estrogen, these two medications work in the brain. They help block a chemical called neurokinin B, which is associated with hot flashes and emotional regulation.
“The medication is very fast acting. Some some studies have shown effects within a week,” Maki said. Estrogen starts working after a few weeks but takes months to get a full therapeutic benefit. That’s “because it goes directly to the source of the hot flash.”
Doctors can also prescribe anti-depressants to treat these symptoms, though only one (paroxetine, aka Brisdelle) is FDA-approved for this use.
“I think the more options we have, the more women we can help,” Maki said.
