Vasomotor symptoms (VMS) are the primary symptoms of menopause.1 They occur in 50–82% of women and persist for an average of 7.4 years.1,2 VMS are noted for their significant and persistent impact on quality of life (QoL), negatively affecting sleep quality, mood, cognitive function and mental wellbeing.1,2 People with VMS have also reported muscle aches and lower back pain as bothersome and impactful on QoL.3
The Impact of VMS on Women’s Daily Lives
Dr Juliana (Jewel) Kling (Mayo Clinic, Scottsdale, Arizona, USA) explains how menopause symptoms and VMS affect the daily lives of women.
VMS-associated sleep disturbance is a potential root cause of some aspects of the associated mental health impact, including depressed mood and impaired cognitive function.1,2,4 The effect of VMS on mental health continues to be explored but is recognised to be significant.5,6
The impact of VMS on women’s physical and mental wellbeing has socioeconomic implications relating to decreased workplace productivity and social impairment, further reducing QoL.2,7-11 There are also costs associated with the management of VMS. These include healthcare costs, but also missed monetary gain due to impeded progression in the workplace as a consequence of VMS-associated burdens.8
While the full extent of VMS burden is yet to be fully reported, it is clear that the impacts of VMS are diverse and take a substantial toll on QoL.
The healthcare system is largely unprepared to help women manage VMS.7 Contributing factors include:7
A move away from hormone therapy because of safety concerns expressed by patients
A number of conditions that contradict typical VMS treatment
A lack of alternative therapeutic options
A gap in postgraduate medical training
People experiencing VMS are notably undertreated.12 A quarter of women with VMS have never received prescription treatment, and many women who have received treatment reported poor symptom control or dissatisfaction with treatment.13 One contributing factor may be a tendency of healthcare professionals to underestimate the impact and burden of VMS.3,14 Hesitancy around hormone therapy may also be a factor.13
Addressing unmet needs in VMS
To adequately address the unmet needs of women with VMS, there must be recognition that these symptoms are much more than an annoyance or nuisance.15
Unmet Needs in VMS
Dr Kling highlights the unmet needs of women experiencing VMS.
As an aspect of treatment, regular inquiry into the frequency and severity of hot flashes can inform treatment efficacy and assist in understanding patient experience to better personalise treatment options.15
Availability of therapeutic options continues to be a significant factor in the experience of women with VMS. Oestrogen-based hormone therapy remains the most effective option available and is suitable for most women with VMS (57.3%) but is not suitable for everyone13. This is in part due to individual preference, with 62.7% of physicians reporting hesitancy among women with VMS around the use of hormone therapy.13 Women may also have a medical history that suggests an elevated risk of adverse effects, such as a history of breast cancer.13,15 The unmet needs of this population may be better addressed as alternative treatments become available, such as selective serotonin reuptake inhibitors / serotonin and norepinephrine reuptake inhibitors and neurokinin 3 receptor antagonists.12,15
Developed independently by EPG Health, which received an educational grant from Heartbeat, on behalf of Astellas, to help provide its healthcare professional members with access to the highest quality medical and scientific information, education and associated relevant content.
