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For too long, our understanding of Vasomotor Symptoms (VMS), also known as hot flashes and night sweats, has been limited to the role of estrogen alone. Finally, new science has revealed a more complete picture.1,2
We now know that VMS results from altered activity of the kisspeptin/neurokinin B/dynorphon (KNDy) neurons in the temperature control center of the hypothalamus1,3
Vasomotor Symptoms can be a serious medical condition associated with menopause.4
- Inside the thermoregulatory center in the hypothalamus, specific neurons known as kisspeptin/neurokinin B/dynorphin neurons, or KNDy neurons, contribute to regulation of the body’s temperature3
- KNDy neurons are inhibited by estrogen and stimulated by the neuropeptide neurokinin B (NKB) in a delicate balance5,6
- Through the menopausal transition, declining estrogen disrupts the balance with NKB. Unopposed, NKB signaling increases KNDy neuronal activity—leading to hypertrophy of the KNDy neuron and altered activity on the thermoregulatory center3,5,7
- As a result, the thermoregulatory center triggers heat dissipation effectors that are experienced as hot flashes and night sweats, or VMS3,7
Recent studies have shown that the frequency and severity of VMS may be used as a biomarker for chronic diseases in the future regarding cognitive impairment, cardiovascular disease, and bone health.8
Current FDA-approved treatment classes for hot flashes and night sweats include hormone therapy (HT) and SSRI.* Other treatment strategies include over-the-counter remedies like supplements and herbs. Each of these options has varying levels of efficacy and safety.9
Even though HT has long been the standard of care, new science suggests that estrogen is not the only cause of VMS.1,2
*SSRI=selective serotonin reuptake inhibitor.In the US, up to 80% of women are affected by VMS during the menopausal transition.4 VMS lasts for a median duration of 7.4 years, and women living with VMS reported a negative impact on sleep (82%), mood (69%), concentration (69%), energy (63%), sexual activity (41%), work (46%), social activities (44%), and leisure activities (48%).10
However, not all women experience VMS to the same extent—in the US, VMS affects a higher percentage of African American and Hispanic women, 46% and 34%, respectively, vs 31% of White women. In addition, African American women and Hispanic women experience symptoms for 2-4 years longer than White women.11,12
Not all women realize that VMS are a medical condition worthy of discussion, therefore many go undiagnosed or untreated.12,13 Having a productive dialogue is crucial in helping women impacted by VMS. Studies show that women want to have open and honest conversations about menopause symptoms and treatment options with their doctor.13
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