A review of African American women's experiences in menopause

Williams, Makeba; Richard‐Davis, Gloria; Williams, Peter; Christensen, Leslie; Ward, Earlise C.; Schrager, Sarina

doi:10.1097/gme.0000000000002060

Cited by 9 publications

(7 citation statements)

References 43 publications

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“…Cultures ascribe varied meaning to the transition, with some reflecting distress about loss of youth, whereas others consider this a natural part of aging so women are less likely to seek care 2021. In the Study of Women’s Health Across the Nation (SWAN) cohort in the US, Black women experienced more severe and longer lasting symptoms than other women, a fact that warrants more attention and is also difficult to disentangle from the effects of structural racism 2223. Clinicians can more effectively address menopausal symptoms and invite conversations by educating themselves about their patients’ cultural contexts around menopause.…”

Section: Epidemiology and Physiology Of Menopausementioning

confidence: 99%

Management of perimenopausal and menopausal symptoms

Duralde

Sobel

Manson

2023

BMJ

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Most women worldwide experience menopausal symptoms during the menopause transition or postmenopause. Vasomotor symptoms are most pronounced during the first four to seven years but can persist for more than a decade, and genitourinary symptoms tend to be progressive. Although the hallmark symptoms are hot flashes, night sweats, disrupted sleep, and genitourinary discomfort, other common symptoms and conditions are mood fluctuations, cognitive changes, low sexual desire, bone loss, increase in abdominal fat, and adverse changes in metabolic health. These symptoms and signs can occur in any combination or sequence, and the link to menopause may even be elusive. Estrogen based hormonal therapies are the most effective treatments for many of the symptoms and, in the absence of contraindications to treatment, have a generally favorable benefit:risk ratio for women below age 60 and within 10 years of the onset of menopause. Non-hormonal treatment options are also available. Although a symptom driven treatment approach with individualized decision making can improve health and quality of life for midlife women, menopausal symptoms remain substantially undertreated by healthcare providers.

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Section: Epidemiology and Physiology Of Menopausementioning

confidence: 99%

Management of perimenopausal and menopausal symptoms

Duralde

Sobel

Manson

2023

BMJ

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“…[1][2][3][4] However, VMS has been a historically under-researched area with limited treatment options, despite affecting women's overall quality of life. [5][6][7] Recently, there has been increasing interest in understanding the mechanisms of hot flushing and the potential role of various treatments, such as selective serotonin reuptake inhibitors (SSRIs). The U.S. Food and Drug Administration approved a New Drug Application for Fezolinetant, which is an investigational, non-hormonal, oral compound for use in menopausal women undergoing moderate to severe VMS.…”

Section: Introductionmentioning

confidence: 99%

Neurokinin 1/3 receptor antagonists for menopausal women: A current systematic review and insights into the investigational non-hormonal therapy

Hassan¹,

Saleem²,

Samuel³

et al. 2023

Medicine

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Background: Over 75% of menopausal women experience vasomotor symptoms (VMS), such as night sweats and hot flashes. Despite the prevalence of these symptoms, there is limited data on non-hormonal therapies to alleviate them. Methods: PubMed, Cochrane, Scopus, Ovid, Web of Science, and ClinicalTrials.Gov were searched for relevant studies. The search was performed using the following keywords, which were customized to suit the specific databases/registers: menopause, women, neurokinin 3, and/or Fezolinetant. The search was conducted until December 20, 2022. This systematic review was conducted in compliance with the PRISMA Statement 2020 guidelines. Results: A total of 326 records were found, with 10 studies (enrolling 1993 women) selected for inclusion. The women received 40-mg doses of NK1/3 receptor antagonists twice daily, with follow-ups at 1 to 3 weeks. Moderately strong evidence was found suggesting that NK1/3 receptor antagonists can help limit the frequency and severity of hot flashes in menopausal women. Conclusion: While the results should be interpreted with caution until further clinical trials validate the efficacy and safety of NK1/3 receptor antagonists among menopausal women, these findings suggest that they are promising targets for future pharmacological and clinical studies in addressing vasomotor symptoms.

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“…[2] Despite having a troublesome impact on the overall quality of life (QoL) of perimenopausal and postmenopausal women, vasomotor symptoms (VMS), which include hot flashes and night sweats, remain understudied, with only a few therapy options available. [3,4] The available treatments are not widely accessible (cognitive behavioral therapy [5] ), are limitedly efficacious (e.g., selective serotonin reuptake inhibitors [6] ), cause treatment-related adverse effects, are contraindicated (menopausal hormone therapy [MHT]) in women with personal or family history positive for breast cancer, [7] or are avoided in general due to long-term therapy risks, such as in case of estrogen-progesterone combined hormonal therapy (HT), [8] especially after Women's Health Initiative showed an increased risk of coronary heart disease and breast cancer. [9] A few randomized controlled trials (RCTs) were conducted recently to test the efficacy of neurokinin-3 (NK-3) antagonist, fezolinetant, for treating postmenopausal hot flashes in an effort to discover a novel, effective, and targeted nonhormonal medication for VMS.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of fezolinetant, a neurokinin-3 antagonist, in treating vasomotor symptoms in postmenopausal women: A systematic review and meta-analysis

Rahman,

Kashif,

Usman

et al. 2023

Medicine

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Background: Menopause causes a variety of symptoms such as hot flashes and night sweats. While menopausal hormonal therapy has been used for managing postmenopausal vasomotor symptoms (VMS) for quite a while, it has a considerably poor safety profile. Objective: To review and analyze existing data to evaluate the efficacy of the neurokinin-3 antagonist, fezolinetant, in treating postmenopausal VMS and to assess its safety profile. Methods: A thorough literature search was performed on PubMed, Cochrane Library, and Google Scholar in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020, to find publications on the efficacy of fezolinetant for postmenopausal VMS. Changes in the frequency and severity scores of moderate/severe VMS and changes in the Hot Flash-Related Daily Interference Scale (HFRDIS), Greene Climacteric Scale (GCS), and Menopause-Specific Quality of Life (MENQoL) were the efficacy outcomes. Adverse events, drug-related treatment-emergent adverse effects (TEAEs), drug-related dropouts, hepatotoxicity, endometrial hyperplasia or tumor, and uterine bleeding were all safety outcomes. We used Review Manager 5.4 for pooling risk ratios (RRs) and mean differences (MDs) for dichotomous and continuous outcomes, respectively. A P value of < .05 was considered significant. Results: There was a significant reduction in mean daily VMS frequency at weeks 4 and 12 (MD, −2.36; 95% confidence interval [CI], −2.85 to −1.87; P < .00001, for week 12) and also a significant decrease in VMS severity scores in the treatment group. Furthermore, improvements in MENQoL, HFRDIS, and GCS scores were observed. There was no significant difference in adverse events while drug-related TEAEs (RR, 1.21; 95% CI, 0.90–1.63; P = .21) showed a slight increase with fezolinetant. Drug-related dropouts were again similar across the 2 groups. Uterine bleeding had a lower incidence while endometrial events and hepatotoxicity showed a statistically insignificant, increasing trend in the fezolinetant group. Discussion and implications: Fezolinetant can be a treatment option for postmenopausal VMS but warns of a risk increase in endometrial hyperplasia or tumors. The heterogeneity in the data being analyzed, short follow-up period, and small sample size in most of the included randomized controlled trials were the greatest limitations, which must be considered in further research and safety profile exploration.

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A review of African American women's experiences in menopause

Abstract: African American women may experience menopause differently than women of other ethnic groups. This narrative review synthesizes the literature about the menopausal experiences of African American women.

Cited by 9 publications

References 43 publications

Management of perimenopausal and menopausal symptoms

Management of perimenopausal and menopausal symptoms

Neurokinin 1/3 receptor antagonists for menopausal women: A current systematic review and insights into the investigational non-hormonal therapy

Efficacy and safety of fezolinetant, a neurokinin-3 antagonist, in treating vasomotor symptoms in postmenopausal women: A systematic review and meta-analysis

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