A recently approved medication designed to alleviate menopausal hot flushes has received clearance for use in the United Kingdom, potentially offering benefits to hundreds of thousands of women. Veoza will be accessible through private prescriptions starting this month. However, the National Health Service (NHS) will defer offering the treatment until a comprehensive review by the National Institute for Health and Care Excellence (NICE) is concluded.
Is this a menopause symptom solution?
Menopausal hot flushes, characterized by sudden sensations of heat or cold in the face and upper body, are the most prevalent symptom of menopause, stemming from an imbalance in the brain’s temperature control center. This new medication, also identified as fezolinetant, functions by inhibiting a brain protein responsible for regulating body temperature. While the Medicines and Healthcare products Regulatory Agency (MHRA) has granted approval for the drug’s safety and efficacy, it is still awaiting a recommendation for its inclusion in the NHS. The main hurdle being the cost; Veoza, produced by a Japanese pharmaceutical company, is a daily pill with a price tag of $550 (£430) for a 30-day supply in the US. Faced with financial constraints and diverse health priorities vying for funding, the National Institute for Health and Care Excellence (NICE) will assess the drug’s health benefits in relation to its cost before advising on whether it merits public sector funding here in the UK.
Couple this with the huge waiting lists for access to menopause clinics and to specialist care, it only serves to highlight already well documented health inequities around the menopause and women’s health. Health inequities aside, despite being hailed as a “blockbuster” drug, no medication is a wonder drug or “cure” for menopause. While it represents a significant advancement in alleviating a major symptom, there is still work to be done in this field. Furthermore, its approval in Britain for individuals over 65 is pending, as they were not part of the initial trial. For individuals facing financial constraints, the expense of the medication becomes a barrier to accessing potentially beneficial treatment. Menopausal symptoms can significantly impact one’s quality of life, and pricing medications at a level that is unaffordable for many can exacerbate existing inequalities in healthcare.
Why is a holistic approach favourable?
This situation raises ethical questions about equitable access to medical interventions. Health disparities based on economic status undermine the principle of healthcare as a universal right and can result in unequal health outcomes. In the context of menopausal medications, addressing affordability is crucial to ensuring that all individuals, regardless of their financial situation, have access to effective treatments for managing their health.
Updated draft guidelines from NICE published on November 17th 2023 recommend wider treatment options for managing menopause symptoms as well as enabling a broadened understanding of the risks and benefits of HRT so anyone going through menopause can choose the best care to suit them.
What does our menopause service data tell us?
The severe hot flushes Veoza treats are certainly a major symptom for our MPower by Enable clients and one we promote management of via multiple non-medical modalities like nutrition, herbal supplements and exercise.
MPower’s personalised coaching and peer support service has evidenced a clear pathway to transform the experience of people going through and working with menopause. Through its 1 to 1 coaching and peer group sessions delivered by Menopause Health Coaches in workplaces, it has demonstrated its success in improving psycho-emotional wellbeing, reducing feelings of isolation and equipping participants in self-management so they can be more active in their own care and minimise the disruption the menopause causes their lives and work.
In contrast, potential pitfalls of relying solely on medication, especially if it incurs a significant cost, may not address the root causes of menopause symptoms nor encourage addressing lifestyle habits which may be exacerbating symptoms. Additionally, medications come with side effects, and the financial burden of long-term usage can be substantial.
A holistic approach empowers individuals to actively participate in their well-being, promoting a sense of control and self-care that is sustainable. Lifestyle modifications and coping techniques can contribute to symptom relief without the financial commitment associated with prescription medications.
What role does education and discussion play in managing menopause?
Ultimately, the choice between a holistic approach and medication depends on individual preferences, health considerations, and financial circumstances. Many people find that a combination of both approaches provides a balanced and effective strategy for managing menopause symptoms. Via our bespoke approach MPower’s work informing and educating employers means participants receive personalised, specialist care for their individual menopausal concerns and with this support they have reported that they are better able to cope.
An overwhelming 75% of MPower clients find it easier to discuss menopausal symptoms with line managers of human resources departments after finishing the programme while 81% find the coaching increased their confidence to discuss symptoms with a GP.
One client said: “It’s given me back me! A sense that I can exert more control of managing my symptoms and how I’m feeling as I go through the change. Other ways to look at and manage symptoms. Its helped me see the light at the end of the tunnel.”
Our knowledge and our data shows us that opening the conversation to other holistic methods works.
While Veoza moves in the right direction, any singular treatment should be part of a broader picture, as menopause is not a one size fits all solution but we do know that MPower by Enable sessions were found to successfully reduce the severity of menopause symptoms (regardless of participants’ menopausal stage.) MPower by Enable’s success in fostering confidence, communication, and symptom management only highlights the significance of empowering people through talking therapies combined with other medical and non-medical methods during this transitional period in their life, and by championing discussion around menopause in the workplace and outside of it.
