Special Report: Recent advancements in pharmacologic and nonpharmacologic treatment options

In the seventh episode of the Contemporary OB/GYN Special Report series, JoAnn V. Pinkerton, MD, and Jill Liss, MD, MSCP, FACOG, reviewed recent treatment advancements for vasomotor symptoms (VMS) in menopause, including emerging pharmacologic options and evidence-based nonpharmacologic approaches.

Liss highlighted promising innovation in the field, particularly the development of neurokinin receptor antagonists. “Fezolinetant has been around since 2023, and there’s a new neurokinin drug, elinzanetant, which is anticipated, hopefully, to come around soon,” she said.^1,2 These medications act directly in the brain to regulate thermoregulatory dysfunction, offering effective nonhormonal relief. She also mentioned estetrol (E4) as a potential upcoming option in the hormone therapy landscape.

While pharmacologic options are advancing, Liss noted that nonpharmacologic strategies remain essential, emphasizing the role of cognitive behavioral therapy (CBT) and lifestyle interventions. Pinkerton added that hypnosis has demonstrated benefit for some patients, while acupuncture has shown mixed results but may provide relief for up to six months in certain cases. “The problem is finding somebody who can do this,” she said, referring to hypnosis as a specialized intervention.

Both physicians discussed the growing availability of cooling devices—such as neck fans, air-circulating blankets, and temperature-regulating bedding—but cautioned that evidence for these tools remains limited. “Turning your temperature down to 68 [degrees] probably works about as well as all of those,” Pinkerton observed. Liss agreed, noting that while such products may help some individuals, “by the time they get to our offices, people have spent a lot of money on these things,” and it can delay access to proven treatments.

Our Experts:
JoAnn V. Pinkerton, MD, division director, Midlife Health Center, University of Virginia.

Jill Liss, MD, MSCP, FACOG, associate clinical professor of Obstetrics and Gynecology, University of Colorado School of Medicine.

Liss has no relevant disclosures to report. Relevant disclosures for Pinkerton include Bayer.

References:

1. Elendu C, Okahia TW, Blewusi GS, et al. FDA approves Veozah (Fezolinetant) for menopausal symptoms: a new nonhormonal option. Ann Med Surg (Lond). 2025;87(9):5373-5377. Published 2025 Jul 30. doi:10.1097/MS9.0000000000003670
2. Bayer. Regulatory Update on Elinzanetant. Bayer.com. July 25, 2025. Accessed October 17, 2025. https://www.bayer.com/en/us/news-stories/regulatory-update-on-elinzanetant