Menopausal Vasomotor Symptoms

Updated: May 21, 2023

Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

estrogens esterified/methyltestosterone            

Administer 0.625 mg/1.25 mg orally every day up to 1.25 mg/2.5 mg every day
Administration must be cyclical (e.g., three weeks on, one week off).
At 3- to 6-month intervals, attempts should be made to quit or reduce medication.

estradiol valerate

Indicated for Vulvovaginal atrophy for menopausal
10 mg to 20 mg intramuscularly every four weeks
Hypoestrogenism
10 mg to 20 mg intramuscularly every four weeks
Vasomotor symptoms, moderate to severe menopausal
10 mg to 20 mg intramuscularly every four weeks
Advanced prostate cancer, palliative treatment
>30 mg intramuscularly every one-two weeks
Transgender hormone therapy for feminizing
5 mg to 30 mg intramuscularly every two weeks

dydrogesterone

Continuous sequential therapy (in combination with treatment of estrogen continuously):
10mg orally once daily for two weeks of a 28-day cycle. The dose can be adjusted to 20mg based on the clinical response
Cyclic treatment (in combination with estrogen therapy in a cyclical manner):
10mg orally once daily for the last 12-14 days of treatment with estrogen. The dose can be adjusted to 20mg based on the clinical response

fezolinetant

45mg orally every day
Dosage Modification
Renal Impairment
Moderate or mild (eGFR 30-89 mL/min/1.73 m2): no dosage modification is necessary.
End-stage renal disease (ESRD) or a severe eGFR of 15 to 29 mL/min/1.73 m2 –Contraindicated
Hepatic Impairment
Mild or moderate (Child-Pugh A or B): Observed increased systemic exposure; the prescription label provides no guidelines.

bazedoxifene/conjugated estrogens

This medication is prescribed to alleviate vasomotor symptoms that occur as a result of menopause
The recommended dose is 20 mg/0.45 mg (1 tablet) taken orally once a day

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