Dr Divia Mohandas1, Dr Tessa Weir1
1Nepean Hospital, Kingswood, Australia
Biography:
Dr D is a dual trainee in General Medicine and Endocrinology, currently a second-year Endocrinology Advanced Trainee at Nepean Hospital. She completed Basic Physician Training at Nepean and has worked as a General Medicine Advanced Trainee at Blacktown Hospital and Launceston General Hospital. Her interests include diabetes, women’s health, reproductive endocrinology, osteoporosis, and obesity. She was a Menopause Fellow at Westmead Hospital and contributed to establishing its menopause service. She is passionate about medical education and is a member of Endocrine Society of Australia, Australian Diabetes Society, and Australasian Menopause Society.
Vasomotor symptoms (VMS) significantly impair quality of life in menopausal women. Menopausal hormone therapy (MHT), while effective, is often contraindicated in women with a history of hormone-sensitive malignancy or thromboembolic disease. Veoza (fezolinetant), a neurokinin 3 receptor antagonist, offers a novel non-hormonal treatment option.
We report a 52-year-old postmenopausal woman with severe VMS, including frequent hot flushes, night sweats, sleep disturbance, and mood impairment. Her history was significant for prior breast cancer, strong family history of breast malignancy, and previous deep vein thrombosis, precluding MHT use. Baseline symptom burden was high, with a Menopause-Specific Quality of Life (MENQOL) vasomotor score of 7/9.
Following initiation of fezolinetant, she reported marked symptomatic improvement. MENQOL vasomotor scores improved to 4.2/8, with notable gains in sleep quality and mood. Treatment was well tolerated, with no adverse effects and stable liver function.
This case highlights the real-world effectiveness of fezolinetant in a high-risk patient population and demonstrates the utility of MENQOL scoring in monitoring response. Fezolinetant represents a promising non-hormonal option for managing VMS where MHT is contraindicated.