VMS management: An internist’s view
Transcript: Pathophysiology of VMS
Dr Lisa Larkin
All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
So this is a very exciting time in menopause management. So thanks to a lot of really tremendous basic science research, we really have developed a better understanding of the pathophysiology of vasomotor symptoms, which has led to very exciting drug development and advances in the space. What we've known for a long time is that oestrogen plays a key role in the development of vasomotor symptoms, but oestrogen is not the whole story.
All women, as they transition through menopause, will have declining oestradiol levels as ovarian function stops. What we know though, is not all women experience vasomotor symptoms, so we knew it had to be more complicated than that. Thanks to great basic science research, we now understand that there's a complex process in the brain that controls the thermoregulatory centre.
So it involves these new group of neurons in the brain that we understand called KNDy neurons that project into the hypothalamus that are regulated between this delicate balance of oestrogen and NKB. We know that it's this balance between this molecule, this NKB and oestrogen, that leads to the stimulation of these neurons into the hypothalamus, and that controls the thermal regulatory centre. In the absence of oestrogen, NKB predominates. That causes these neurons to be hyperstimulated, which leads to narrowing of the thermal regulatory zone and leads to this hot flash that women experience.
Thanks to this basic science research and understanding of this mechanism, we've now been able to develop medications. There's one currently FDA approved that specifically targets this pathway to treat vasomotor symptoms. And so this is a very exciting time in menopause management. And this new drug development has led to us having another tool in our toolbox to treat vasomotor symptoms.
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