Menopause is a natural stage of life, but it often brings uncomfortable symptoms. One of the most common is vasomotor symptoms, which include hot flashes and night sweats. These can affect up to 70% of women and can interfere with sleep, daily activities, and overall quality of life.
Hormone therapy has long been the most effective treatment, but it is not the right choice for everyone. Because of this, researchers have been working on new, nonhormonal options. Two newer prescription medications, Fezolinetant (Veoza™) and Elinzanetant (Lynkuet™), are being studied as alternatives.
Why Hot Flashes Happen
Hot flashes are caused by changes in how the brain controls body temperature. During menopause, estrogen levels drop, which affects a part of the brain called the hypothalamus.
This disruption makes the body think it is overheating, even when it is not. As a result, the body tries to cool itself down quickly, leading to sweating and sudden waves of heat. These symptoms often happen at night, which is why many women also deal with poor sleep during menopause.
How Researchers Studied These Medications
This study combined results from several high-quality clinical trials to get a clearer picture of how well these medications work.
This review Included 7 randomized, meaning either Fezolinetant or Elinzanetan were assigned like flipping a coin. The trials studied 4,087 women with menopause symptoms and the medications were compared to a placebo which has no active drug.
Researchers looked at how often hot flashes happened, how severe they were, sleep quality, overall quality of life, and side effects. Combining multiple studies makes the findings more reliable.
What the Results Showed
Both Fezolinetant and Elinzanetant helped reduce hot flashes overall, but there were some important differences.
Women taking either drug had fewer and less intense hot flashes.
Sleep outcomes stood out. Elinzanetant led to a large improvement in sleep quality, while Fezolinetant showed only a small benefit. This may be because Elinzanetant affects more pathways in the brain.
Both medications also improved quality of life, meaning women felt better in their daily routines and were less impacted by symptoms.
Side Effects: What did the research show?
Fezolinetant (Veoza™)
- No clear increase in drug-related side effects compared to placebo
- Generally well tolerated
- Similar rates of headaches compared to placebo
- No significant increase in serious side effect
Elinzanetant (Lynkuet™)
- More drug-related side effects overall
- Higher rates of headaches
- Increased occurrence of treatment-related adverse events compared to placebo
Serious side effects were rare for both medications.
How This Could Change Treatment
These findings give more options to women who cannot or do not want to use hormone therapy.
The research stated that Fezolinetant may be a better choice for milder symptoms or for those concerned about side effects. Elinzanetant may be more helpful for women with more severe symptoms, especially if sleep problems are a major issue.
Treatment decisions will likely be based on individual symptoms and preferences.
What Still Needs More Research
There are still some limitations to consider. There were differences in how the medications were dosed across the studies, which makes direct comparisons more difficult. The total number of studies was also relatively small, even though the results were consistent.
Researchers also need more direct comparisons between these medications and other nonhormonal treatments to better understand how they stack up.
More research will help confirm and refine these findings.
The Bottom Line
Nonhormonal treatments for menopause are improving.
- Both Fezolinetant and Elinzanetan reduce hot flashes and improve quality of life
- Elinzanetant appeared more effective, especially for sleep
- Fezolinetant may have fewer side effects
These options provide you and your healthcare provider more flexibility for managing menopause symptoms and represent an important step forward in care.
Source
Menegaz de Almeida A, Oliveira P, Lopes L, Leite M, Morbach V, Kelly FA, Barros I, Moraes FCA, Prevedello A. Fezolinetant and elinzanetant therapy for menopausal women experiencing vasomotor symptoms: a systematic review and meta-analysis. Obstet Gynecol. 2025;145(3):253–61. Available from: https://journals.lww.com/greenjournal/abstract/2025/03000/fezolinetant_and_elinzanetant_therapy_for.3.aspx
