Real-World Nonhormonal Therapy Effects on VMS Bother, Work, and Mood

Pauline M. Maki, PhD, reviews the first data cuts from OPTION-VMS, released at The Menopause Society 2025 meeting. These analyses examined bother from VMS, meaning hot flashes and night sweats, using the MENQOL, a commonly used measure of vasomotor symptom (VMS) bother, along with a widely used measure of workplace productivity.¹

She describes the results as very reassuring because they replicated what was seen in the trials. Where the SKYLIGHT trials showed benefits of fezolinetant (Veozah) on VMS frequency and severity, the original OPTION-VMS data cut showed improvement in women's reported bother from hot flashes. The primary time point was 12 weeks, Maki notes, but improvement was also observed at 4 and 8 weeks, indicating early benefit. In what she calls a critically important outcome, women also reported a substantial boost within 12 weeks in workplace productivity and in activity levels outside of work. This suggests, she explains, that relief from hot flashes and hot flash bother translates to real-world improvement in women's ability to function in daily life.

Maki then turns to new outcome data presented at the Endocrine Society meeting in 2026 on the effects of fezolinetant and other nonhormonal interventions for VMS on depression and anxiety. The study used the PHQ-9 and GAD-7, widely used measures that many providers already have access to in their clinics. Because participants presented to clinics seeking care for VMS, Maki explains, most did not have substantial depression or anxiety at baseline, and levels at the first study visit were minimal. Even with this minimal burden, depression and anxiety improved with fezolinetant after 12 weeks.² As a researcher in women's mental health, she finds this especially interesting, and says it suggests secondary benefits for women whose bothersome menopause symptoms are effectively treated.

In the next segment, Maki explains how wrist-worn actigraphy captures sleep problems women underreport and what it shows with fezolinetant vs SSRIs and SNRIs.