Recent Developments in Pharmacotherapy for Vasomotor Symptoms

Many women experience vasomotor symptoms (VMS) at or around the time of menopause. Hot flashes and night sweats are considered primary menopausal symptoms that may also be associated with sleep and mood disturbances, as well as decreased cognitive function. All of these symptoms may lead to social impairment and work-related difficulties that significantly decrease overall quality of life. Hot flashes have shown a great deal of variability in their frequency and severity in women. In some women, hot flashes persist for several months, but in others, they may last for more than 10 years. Traditionally, VMS were reported to begin after menopause, but night sweats in particular most often begin in perimenopause, several years before the final period. The pathogenesis of hot flashes has not yet been fully elucidated. Hormonal therapy for menopause-associated VMS has been the mainstay for the management of these symptoms for more than 50 years. However, because many women now want to avoid hormone therapy, there is a need for additional targeted therapies, validated by results from controlled clinical trials, that are safe, efficacious, cost-effective, and well tolerated by symptomatic menopausal women. The current status of these new pharmacotherapies for VMS is reviewed.