JoAnn Pinkerton, MD, on starting patients on elinzanetant, what to expect

For primary care clinicians, counseling patients on what to expect from elinzanetant, both its side effects and how quickly it works, can help them stay on therapy, according to JoAnn V. Pinkerton, MD, MSCP, the Mamie A. Jessup Professor of Obstetrics and Gynecology and Division Director for Midlife Health at the University of Virginia. Pinkerton is a co-author on several pooled analyses of the OASIS trials presented at The Menopause Society Annual Meeting 2026 in San Diego, California.

Counseling on side effects

Across elinzanetant’s phase 2 and 3 trials, the most common treatment-emergent adverse events over weeks 1 through 12 were headache, fatigue, and somnolence, though overall frequency was low with both elinzanetant and placebo.¹ Most first-time events were mild or moderate, occurred within the first two weeks of treatment, and resolved over time.¹

“Providers need to talk about the most common side effects,” Pinkerton said, referring to fatigue, headache, and somnolence. “What’s important is that these did improve over time.”

Framing those expectations up front helps patients tolerate early side effects, she said: “If you have side effects, they’re going to get better over time.”

Rapid and continued symptom relief

In a pooled US-population analysis of OASIS-1 and -2, 66.9% of the elinzanetant group achieved at least a 50% reduction in moderate-to-severe vasomotor symptoms (VMS) by week 4, rising to 75.2% by week 26.² In a pooled subgroup analysis of OASIS-1, -2, and -3, numerically greater reductions in VMS frequency and severity with elinzanetant were evident as early as week 1.³

“Patients should expect very rapid improvements within a week in their hot flushes, but then they’re going to have continued improvements over time,” Pinkerton said.

For patients with a slower response, she urged patience, noting that benefit continues to build. “These products work; they improve over time, but they also work very rapidly,” she said.

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References

1. Simon JA, Nappi RE, Panay N, et al. Headache, fatigue, and somnolence as adverse events across elinzanetant’s clinical trials: a pooled safety analysis. Presented at: The Menopause Society Annual Meeting. October 20-24, 2026. San Diego, California.
2. Pinkerton JV, Tough DeSapri K, Clark A, et al. Proportion of postmenopausal participants achieving ≥50% reduction in moderate-to-severe vasomotor symptom frequency with elinzanetant: pooled US population data from OASIS-1 and OASIS-2. Presented at: The Menopause Society Annual Meeting. October 20-24, 2026. San Diego, California.
3. Pinkerton JV, Simon JA, Panay N, et al. Rapid and sustained reductions in VMS frequency and severity with elinzanetant in late perimenopausal women: pooled subgroup analysis from the OASIS-1–3 trials. Presented at: The Menopause Society Annual Meeting. October 20-24, 2026. San Diego, California.