Drugs for the treatment of postmenopausal symptoms: Hormonal and non-hormonal therapy.

Life Sci

Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China; The Academy of Integrative Medicine of Fudan University, Shanghai, China; Shanghai Key Laboratory of Female Reproductive Endocrine-related Diseases, Shanghai, China. Electronic address:

Published: January 2023

AI Article Synopsis

  • - Postmenopausal symptoms arise from a lack of estrogen, and treatments include hormonal therapy (HT) and non-hormonal options, but finding the best approach to balance benefits and risks is still uncertain.
  • - Hormonal therapy is recognized as the most effective treatment, especially when started soon after menopause, though careful consideration of individual risks for chronic diseases is necessary for personalized treatment plans.
  • - New potential treatments, like fezolinetant and vaginal lasers, show promise, but more research is needed for long-term safety and effectiveness; herbal remedies are also used but require further investigation into their side effects.

Article Abstract

Postmenopausal symptoms are systemic symptoms associated with estrogen deficiency after menopause. At present, treatments for postmenopausal symptoms include hormonal therapy (HT) and non-HT. However, the optimal regimen for balancing the benefits and risks remains unclear. This article reviewed the characteristics, regimens, and side effects of drugs used in hormonal and non-HT. However, HT is still the most effective treatment with safety in early initiation since menopause onset. Nevertheless, it is essential to evaluate the risks of related chronic diseases and customize individualized treatments. Possible estetrol preparations and more types of Tissue Selective Estrogen Complex formulations are potential directions of drug development in the future of HT. Regarding non-HT, fezolinetant, currently in phase III clinical trials, is poised to become a first-in-class therapy for vasomotor symptoms. Ospemifene, dehydroepiandrosterone (DHEA), and vaginal lasers can also be used for moderate-to-severe genitourinary syndrome of menopause. Recent data suggest a superior efficacy and safety of vaginal lasers, but more validated evidence of long-term tolerability is needed to respond to the United States Food and Drug Administration warning. Herbal medication commonly used in Asia is effective in alleviating menopausal symptoms; however, its adverse effects still require more detailed reports and standardized observation methods. This review contributes to a better understanding of drugs for the treatment of postmenopausal symptoms and provides useful information for clinical drug selection.

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Source
http://dx.doi.org/10.1016/j.lfs.2022.121255DOI Listing

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