[Reading Science] Menopause Is Also a Disease That Needs Treatment

US FDA to Soon Approve Treatment for Menopausal Syndrome 'Hot Flashes'
Science Community: "Signal to Begin In-Depth Research on Menopause Causes and Physical Effects"

"Menopause is also a disease that needs treatment." Perceptions of menopause, which women experience during the aging process in their 40s and 50s, are changing. Previously, due to taboos surrounding menstruation and the belief that it was a natural phenomenon of aging, women simply had to endure it. However, research on the causes and symptoms is becoming more active, with the first non-hormonal facial flushing treatment drug entering the approval and market stages.

Menopausal Syndrome Symptoms. Photo by Getty Images Bank

According to the international academic journal Nature on the 6th, the U.S. Food and Drug Administration (FDA) is reviewing the approval of fezolinetant, a drug for treating menopausal facial flushing, and is expected to reach a conclusion within the first half of this year. If approved, this drug will become the first non-hormonal treatment for facial flushing symptoms caused by menopause. About 80% of menopausal women complain of facial flushing, characterized by heat and redness in the face. This drug was developed based on a discovery made 30 years ago by a research team at Arizona University, which found that the hypothalamic area related to facial flushing was about twice as swollen in postmenopausal women compared to normal, and it has recently entered the final stages of development.

Scientists studying menopause regard this approval as a signal for serious scientific research into menopause treatment. Until now, research on the causes and effects of menopause in women, which had been neglected due to taboos or considered merely a part of aging, is finally being approached seriously by the scientific community. Nature reported, "Within a few years, the number of menopausal women worldwide is expected to exceed 1 billion," and added, "Based on improved animal models and existing treatment research results, the number of scientists studying menopause is increasing."

They are broadening their understanding of menopause and perimenopause as part of the brain's preparation stage to maintain health in later life. There are even research findings suggesting a connection to neurodegenerative diseases such as Alzheimer's dementia. This means that menopause is no longer simply a condition of the female reproductive system but is shifting the focus of research and development toward neurological causes and effects.

Medically, menopause is defined as the cessation of menstruation for at least 12 consecutive months. It generally occurs in women aged 45 to 55. However, ovarian function does not stop overnight but progresses over several years. Most women experience a fluctuating decline in ovarian function with irregular production of major sex hormones such as estrogen and progesterone over several years. The brain experiences confusion lasting from a few months to around ten years as hormone secretion, including estrogen, which it was accustomed to, becomes irregular. Estrogen plays many roles, including stimulating glucose uptake and energy production. When menopause is complete, brain nerve cells become accustomed to the absence of estrogen, but the problem lies in perimenopause. During this time, fluctuating estrogen levels cause neural circuits in brain cells to fail to adapt, leading to confusion and discord.

As a result, women in perimenopause experience many accompanying symptoms, known as menopausal syndrome. Facial flushing is a representative symptom. They also report anxiety, hypertension, decreased concentration and memory, fatigue, and drowsiness. Until now, these sufferings experienced by perimenopausal women were considered mere physical changes rather than diseases requiring treatment. Hormone replacement therapies studied so far have mostly targeted women who have completed menopause rather than those in severe perimenopause. Experts argue that active treatments must be developed not only to minimize side effects experienced during menopause but also to prevent aging-related diseases such as Alzheimer's dementia that may be triggered afterward. However, the unclear beginning and end of perimenopause remain obstacles to research.

Stacy Missmer, a professor at Michigan State University, USA, said, "Some women have very short perimenopausal symptoms, but for others, they can last for more than ten years," adding, "We currently have no idea how these differences affect the health of these women for the rest of their lives."