How does the menopause drug Veoza work? And how is it different to hormone therapy?

Hot flushes and night sweats – collectively called vasomotor symptoms – are among the most common and disruptive symptoms of menopause.

They affect almost 40% of women in the lead up to menopause, known as perimenopause.

Until 2024, treatment options were largely limited to hormone replacement therapy (HRT).

HRT is very effective for many women.

But some can’t take it because they experience significant side effects or have certain health conditions .

Veoza (fezolinetant) is a drug approved specifically for menopausal vasomotor symptoms.

Unlike HRT, it doesn’t replace naturally declining hormones.

Instead, it blocks signals in the brain’s temperature-control system, which becomes overactive during menopause.

How does it work? Estrogen is involved in temperature regulation, generally acting to lower body temperature.

During perimenopause, declining estrogen levels trigger the activation of a group of brain cells in the hypothalamus known as KNDy (pronounced candy) cells.

When activated, these cells release a signalling molecule called neurokinin B.

This over-stimulates the brain’s temperature regulation system, triggering hot flushes and night sweats.

Veoza blocks the neurokinin 3 receptor (NK3) which means neurokinin B cannot bind to it.

This prevents neurokinin B from delivering its signal and quietens the overactive temperature-control pathway.