Novel Pharmacotherapies for Menopausal Symptoms

Menopausal hormone therapy (HT) is highly effective against vasomotor symptoms (VMS). When HT is contraindicated, ineffective, or unacceptable, alternatives have included antidepressants, antiseizure, and antihypertensive formulations. Novel pharmacologic treatments for VMS have emerged in recent decades, some of which are already approved by the U.S. Food and Drug Administration (FDA) (eg, fezolinetant, a neurokinin 3B antagonist), and others are poised to seek FDA approval (eg, elinzanetant, a dual neurokinin 1B and 3B antagonist, and estetrol, a natural estradiol derivative that is unique to the pregnant state). Oxybutynin was shown to be effective for VMS and could provide additional benefits against overactive bladder, but long-term safety data are needed before wider utilization can be recommended.