VMS needs a temperature check


70% of women
who
experience
moderate to
severe
VMS go untreated1

Vasomotor Symptoms (VMS), also known as hot flashes and night sweats, are the most bothersome symptoms of menopause. While the number of women aged 40-65 is projected to grow, many will experience VMS and remain untreated.1-3

In the past two decades, there has been an 84% decline in FDA-approved hormone therapy prescriptions for menopause-related symptoms4

Hormone therapy (HT) remains the standard of care for VMS,
but it may not be appropriate for every patient.5-7

HORMONE THERAPY RX VOLUMES

Treatment strategies for
VMS5,8-11:

TREATMENT

Estrogen therapy

SAFETY

  • Adverse events include breast tenderness, vaginal bleeding, and bloating
  • Includes a boxed warning that refers to stroke, deep vein thrombosis, endometrial cancer, and dementia; estrogen therapy should not be used for the prevention of cardiovascular disease or dementia

EFFICACY

Up to 75% reduction in frequency and 87% reduction in severity

TREATMENT

Estrogen-progestin therapy

SAFETY

  • Adverse events include breast tenderness, vaginal bleeding, and bloating
  • Includes a boxed warning that refers to stroke, deep vein thrombosis, pulmonary emboli, myocardial infarction, invasive breast cancer, and dementia; estrogen therapy should not be used for the prevention of cardiovascular disease or dementia

EFFICACY

Up to 75% reduction in frequency and 87% reduction in severity

TREATMENT

Estrogen combined with estrogen agonist/antagonist

SAFETY

  • Adverse events include infection, pain, arthralgia, and headache
  • Includes a boxed warning that refers to stroke, deep vein thrombosis, endometrial cancer, dementia, and use with additional estrogens; estrogen therapy should not be used for the prevention of cardiovascular disease or dementia

EFFICACY

74% reduction in frequency and significant reductions in severity

Other forms of estrogen and progestin may have different risks, such as lower risk of various thromboembolism with transdermal estrogen vs oral estrogen (as indicated by some observational studies). Estrogens with or without progestins should be prescribed at the lowest effective doses and for the shortest duration consistent with treatment goals and risks for the individual woman.

In women with a uterus who use unopposed estrogens.

In postmenopausal women 65 years of age and older.

TREATMENT

SSRI§

SAFETY

  • Adverse events include nausea, headache, and dizziness
  • Includes boxed warning for suicidal thoughts and behaviors in pediatrics and young adults

EFFICACY

33–65% reduction in frequency and significant reductions in severity

§SSRI=selective serotonin reuptake inhibitor.

TREATMENT

Supplements and
herbal therapies

SAFETY

No evidence of safety concerns

EFFICACY

Inconsistent evidence of clinical benefit more than placebo

It’s time to take
VMS off the
back burner


Healthcare is trending toward targeted treatment, but VMS is lacking innovation. Other menopausal conditions like vulvovaginal atrophy (VVA) and osteoporosis have seen targeted innovations; however, VMS has seen very few.5,6,12

Women need more information about VMS


Some women struggle to differentiate burdensome symptoms
like VMS from the life stage of menopause.13

Eighty percent of women were aware of menopause
Yet only sixteen percent had knowledge about their VMS symtomps and health implications

It’s time to educate
women about VMS


Research shows that women want6:

Open an honest conversationsOpen and honest
conversations
Facts about diagnosisFacts about diagnosis
Credible treatment information Credible treatment
information
VMS IN HER WORDS - It’s like a snowball [effect]; I don’t sleep well, then I wake up tired, and because I am tired, I am irritable. [Then] I get mad at myself when I am irritable because I should be patient with people, especially the ones that I love.

Find tools to help you raise awareness of VMS in your practice

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References: 1. Sarrel P, Portman D, Lefebvre P, et al. Incremental direct and indirect costs of untreated vasomotor symptoms. Menopause 2015;22(3):260-6. 2. Carpenter JS, Woods NF, Otte JL, et al. MsFLASH participants' priorities for alleviating menopausal symptoms. Climacteric 2015;18(6):859-66. 3. Ortman JM, Velkoff VA, Hogan H. An aging nation: the older population in the United States, Current Population Reports, P25-1140. US Census Bureau, Washington, DC. 2014. 4. IQVIA ISMART Dataset. TRx Volume for Oestrogens and Oestrogen + Progestogens. 1992-2020. 5. Pinkerton JV. Hormone therapy for postmenopausal women. N Engl J Med 2020;382(5):446-55. 6. Parish SJ, Nappi RE, Kingsberg S. Perspectives on counseling patients about menopausal hormone therapy: strategies in a complex data environment. Menopause 2018;25(8):937-49. 7. Thurston RC. Vasomotor symptoms. In: Crandall CJ, Bachman GA, Faubion SS, et al., eds. Menopause Practice: A Clinician’s Guide. 6th ed. Pepper Pike, OH: The North American Menopause Society, 2019:43-55. 8. Kaunitz AM, Manson JE. Management of menopausal symptoms. Obstet Gynecol 2015;126(4):859-76. 9. Goldberg T, Fidler B. Conjugated Estrogens/Bazedoxifene (Duavee): a novel agent for the treatment of moderate-to-severe vasomotor symptoms associated with menopause and the prevention of postmenopausal osteoporosis. P T 2015;40(3):178-82. 10. Carroll DG, Lisenby KM, Carter TL. Critical appraisal of paroxetine for the treatment of vasomotor symptoms. Int J Womens Health 2015;7:615-24. 11. Fornaro M, Anastasia A, Valchera A, et al. The FDA “Black Box” Warning on antidepressant suicide risk in young adults: more harm than benefits? Front Psychiatry (Epub) 05-03-2019. 12. Adler RA, El-Hajj Fuleihan G, Bauer DC, et al. Managing osteoporosis in patients on long-term bisphosphonate treatment: report of a task force of the American Society for Bone and Mineral Research. J Bone Miner Res 2016;31(1):16-35. Erratum in: J Bone Miner Res 2016;31(10):1910. 13. Nusrat N, Nishat Z, Gulfareen H, Aftab M, Asia N. Knowledge, attitude and experience of menopause. J Ayub Med Coll Abbottabad 2008;20(1):56-9.

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