New Drug Approval: How Does the Brain Change with Menopause?

On May 12, the Food and Drug Administration (FDA) approved Fezolinetant to treat hot flashes caused by menopause. This drug is a Neurokinin 3 (NK3) receptor antagonist. That is, it blocks the activity produced by the NK3 receptor in the central nervous system. This receptor plays a fundamental role in regulating body temperature.

The drug’s approval marks a milestone as it is the first non-hormonal treatment that can help control both moderate and severe hot flashes. According to the FDA, 80% of menopausal women suffer from hot flashes and these “may include periods of sweating, flushing of the face, and chills that last several minutes.” Consequently, this symptom affects the quality of life of women. Also, hormone treatments are not always an option. For example, women with a history of cardiovascular accident, migraines and certain types of breast cancer cannot have this type of treatment.

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The relationship between the brain and menopause

This approval would not be possible if it were not for neuropathologist Naomi Rance, a forerunner in the 1990s of studies linking the brain and menopause. It was she who discovered brain cells in the hypothalamus of postmenopausal women that were much larger than those of premenopausal women. These cells, called KNDy, respond to the neurokinin B molecule. These early steps are what allowed Fezolinetant to be used today to treat this symptom of menopause.

In her report on the discovery, science journalist Heidi Ledford says that for both Rance and others in the field, this is a breakthrough in attention and seriousness that is finally being put to study the causes and effects of symptoms. of menopause. It also draws attention to the limitations to medical services related to menopause that millions of women around the world have.

The latter is very important, since menopause is one of the natural processes that carries the most stigma in society. In recent decades, we have seen a normalization of other processes, such as menstruation. However, menopause remains a difficult topic to talk about, even in feminist circles. There are very few spaces that work towards the normalization of menopause and, in that order, public policies focused on the care and well-being of women going through this process are not required.

Let us remember that menopause is a process that can last at least 12 months and that, although it occurs calmly and comfortably in some women, there are many more cases in which ovarian decline is irregular and the production of sex hormones is erratic. . This process, which is often mistakenly associated with mere mood swings, implies a gigantic change in the body that is accompanied by symptoms that are still little studied. Added to this is the fact that hormonal treatments, which are the rule , mean a higher risk of hip fractures, urinary incontinence, dementia, vaginal bleeding, breast cancer, strokes, blood clots and heart attacks, according to the National Institute of Cancer (NIH).

In this sense, research focused on menopause is not only important, but necessary. In addition, according to Ledford, these studies that focus on the neurological causes and effects of menopause could contribute to research on brain health in adulthood and even correlate with neurodegenerative diseases such as Alzheimer’s.

Without a doubt, the approval of Fezolinetant means a great advance for studies around the menopause and also for a public health policy that ensures both reproductive and neuronal health care for women at all stages of their lives.