Feeling the Heat? Your Brain Might Be Behind Those Menopause Hot Flashes!

Is menopause leaving you feeling flushed and frustrated? Maybe your hot flashes and night sweats are not just the results of your hormonal imbalance. Your brain and the way it works might be involved, too.

“In the past, it was believed that menopause and associated vasomotor symptoms were the result solely of the decrease in estrogen; research in this field has revealed the role of specific neural pathways located in the hypothalamus, the area of the brain that regulates body temperature, in causing hot flashes,” says Prof. Rossella Nappi, Professor of Obstetrics and Gynecology at the University of Pavia and President of the International Menopause Society (IMS), who I met in Milan during the press conference for the launch of Fezolinant a new treatment by Astellas Pharma.

“The hypothalamus is responsible for the control and regulation of all the reproductive mechanisms in women. One brain function that is particularly affected by the drop in estrogen is thermoregulation, or the brain’s ability to read the external temperature of the body correctly”, she explains. “As a result, the primary symptom of menopause is represented by hot flashes, which originate in the hypothalamus and can last from a few seconds to several minutes. The incorrect reading of the body’s internal thermostat by a group of neurons in the hypothalamus triggers a chain reaction, causing sudden vasodilation.“

Fortunately, Fezolinant has the potential to revolutionize how women manage hot flashes and night sweats. This new medication could offer a much-needed solution for those women who can’t or do not want to take the HRT.

It’s a new oral, non-hormonal therapy that may reduce moderate to severe vasomotor symptoms (VMS) associated with menopause by blocking the neurokinins involved in the body’s thermoregulation, helping to restore balance in the brain’s temperature control centre (the hypothalamus) to reduce the number and intensity of hot flashes and night sweats.

“It’s a very sophisticated mechanism of action that acts directly at the root cause of the symptoms,” explains Tommaso Simoncini, Professor of Gynecology and Obstetrics at the University of Pisa and President of the International Society of Gynecological Endocrinology (ISGE). “This is an important advantage as it allows clinicians to personalize therapy“.

Globally, more than half of menopausal women experience VMS, with rates in Europe ranging from 56% to 97%, with a prevalence of moderate to severe cases in post-menopause of 40%. But clearly, we shouldn’t let hot flashes control our lives.

“Unfortunately, menopause is burdened by stigma and distorted perception, leading it to be considered a natural event that has always affected all women and that women should simply accept. This approach needs to change“, Prof. Nappi says. “Today, a 50-year-old woman is still active and has a long life expectancy ahead of her. We know that menopause and its symptoms can significantly affect the health of many organs and systems, even many years later. It is therefore necessary to protect women and their future health, and today this is possible thanks to advances in research that have made effective and safe non-hormonal medications available.”

It is time to recognize that this natural transition in a woman’s life can have significant health implications. By understanding and addressing the symptoms of menopause, we can empower women to lead healthier and more fulfilling lives. With the advancements in non-hormonal treatments, there is hope for a future where menopause is no longer a source of fear or discomfort, but rather a phase of life that is embraced with knowledge and support.

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