New advances in menopause symptom management

IF 6.1 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Best practice & research. Clinical endocrinology & metabolism Pub Date : 2024-01-01 DOI:10.1016/j.beem.2023.101774
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)
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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.

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更年期症状管理的新进展
血管运动症状(VMS)是 75% 以上绝经后妇女的更年期特征,对健康和社会经济有重大影响。虽然症状的平均持续时间为 7 年,但有 10% 的妇女症状持续时间超过 10 年。尽管绝经激素疗法(MHT)仍然是一种有效且经济的治疗方法,但并非所有妇女都适合使用这种疗法,例如那些罹患乳腺癌或妇科恶性肿瘤风险较高的妇女。据推测,神经激肽 B(NKB)信号通路及其与视前中核(MnPO)的复杂联系可提供综合的生殖和体温调节反应,并在介导绝经后 VMS 方面发挥核心作用。这篇综述介绍了下丘脑-垂体-卵巢(HPO)轴的生理结构,并随后利用动物和人体研究中获得的证据,介绍了随着绝经而发生的神经内分泌变化。最后,还回顾了使用拮抗 NKB 信号传导的新型治疗药物进行的最新临床试验数据。
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来源期刊
CiteScore
11.90
自引率
0.00%
发文量
77
审稿时长
6-12 weeks
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.
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