Kanyada Koysombat MBBS BSc (Specialist Registrar in Endocrinology and Diabetes / NIHR Academic Clinical Fellow) , Patrick McGown MBBS BSc (Specialist Registrar in Endocrinology and Diabetes) , Sandhi Nyunt MBBS MSc (Specialist Registrar in Endocrinology and Diabetes) , Ali Abbara MBBS BSc PhD (Clinical Senior Lecturer / Honorary Consultant in Endocrinology / NIHR Clinician Scientist) , Waljit S. Dhillo MBBS BSc PhD (Professor in Endocrinology and Metabolism / Consultant Endocrinologist / NIHR Senior Investigator, Dean of the NIHR Academy, Head of Division of Diabetes, Endocrinology and Metabolism, ICHT Divisional Director of Research for the Division of Medicine & Integrated Care)
{"title":"New advances in menopause symptom management","authors":"Kanyada Koysombat MBBS BSc (Specialist Registrar in Endocrinology and Diabetes / NIHR Academic Clinical Fellow) , Patrick McGown MBBS BSc (Specialist Registrar in Endocrinology and Diabetes) , Sandhi Nyunt MBBS MSc (Specialist Registrar in Endocrinology and Diabetes) , Ali Abbara MBBS BSc PhD (Clinical Senior Lecturer / Honorary Consultant in Endocrinology / NIHR Clinician Scientist) , Waljit S. Dhillo MBBS BSc PhD (Professor in Endocrinology and Metabolism / Consultant Endocrinologist / NIHR Senior Investigator, Dean of the NIHR Academy, Head of Division of Diabetes, Endocrinology and Metabolism, ICHT Divisional Director of Research for the Division of Medicine & Integrated Care)","doi":"10.1016/j.beem.2023.101774","DOIUrl":null,"url":null,"abstract":"<div><p><span>Vasomotor<span><span> symptoms (VMS) are characteristic of menopause experienced by over 75% of postmenopausal women<span> with significant health and socioeconomic implications. Although the average duration of symptoms is seven years, 10% of women experience symptoms for more than a decade. Although menopausal hormone therapy (MHT) remains an efficacious and cost-effective treatment, its use may not be suitable in all women, such as those at an increased risk of breast cancer or gynaecological </span></span>malignancy<span>. The neurokinin B<span><span> (NKB) signaling pathway, together with its intricate connection to the median </span>preoptic nucleus (MnPO), has been postulated to provide integrated reproductive and thermoregulatory responses, with a central role in mediating postmenopausal VMS. This review describes the physiological hypothalamo-pituitary-ovary (HPO) axis, and subsequently the neuroendocrine changes that occur with menopause using evidence derived from animal and human studies. Finally, data from the latest </span></span></span></span>clinical trials using novel therapeutic agents that antagonise NKB signaling are reviewed.</p></div>","PeriodicalId":8810,"journal":{"name":"Best practice & research. Clinical endocrinology & metabolism","volume":null,"pages":null},"PeriodicalIF":6.1000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Best practice & research. Clinical endocrinology & metabolism","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1521690X23000453","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ENDOCRINOLOGY & METABOLISM","Score":null,"Total":0}
引用次数: 0
Abstract
Vasomotor symptoms (VMS) are characteristic of menopause experienced by over 75% of postmenopausal women with significant health and socioeconomic implications. Although the average duration of symptoms is seven years, 10% of women experience symptoms for more than a decade. Although menopausal hormone therapy (MHT) remains an efficacious and cost-effective treatment, its use may not be suitable in all women, such as those at an increased risk of breast cancer or gynaecological malignancy. The neurokinin B (NKB) signaling pathway, together with its intricate connection to the median preoptic nucleus (MnPO), has been postulated to provide integrated reproductive and thermoregulatory responses, with a central role in mediating postmenopausal VMS. This review describes the physiological hypothalamo-pituitary-ovary (HPO) axis, and subsequently the neuroendocrine changes that occur with menopause using evidence derived from animal and human studies. Finally, data from the latest clinical trials using novel therapeutic agents that antagonise NKB signaling are reviewed.
期刊介绍:
Best Practice & Research Clinical Endocrinology & Metabolism is a serial publication that integrates the latest original research findings into evidence-based review articles. These articles aim to address key clinical issues related to diagnosis, treatment, and patient management.
Each issue adopts a problem-oriented approach, focusing on key questions and clearly outlining what is known while identifying areas for future research. Practical management strategies are described to facilitate application to individual patients. The series targets physicians in practice or training.