Abstract

Introduction: In recent years, menopausal hormone therapy has fallen out of favor due to safety concerns. As result, there is a need for effective and safe non-hormonal therapies to manage vasomotor symptoms associated with menopause.
Objective: To evaluate the efficacy and safety of neurokinin 3 receptor antagonists for the treatment of menopausal vasomotor symptoms.
Materials and methods: Randomized controlled trials, systematic reviews, narrative reviews, and metaanalyses were included. Search was conducted across multiple electronic databases, including MEDLINE via PubMed, CENTRAL, CINAHL, and the Cochrane Database of Systematic Reviews (Wiley platform), among others, using both free-text and controlled vocabulary terms. The search covered the period from 1995 to 2026 without language restrictions.
Results: A total of 67 articles were identified, including 8 placebo-controlled clinical trials involving 6,270 participants. Women received fezolinetant, a neurokinin 3 receptor antagonist. Evidence suggests that NK3 receptor antagonists reduce both the frequency and severity of hot flashes in menopausal women.
Conclusion: To date, NK3 receptor antagonists have demonstrated a rapid and meaningful reduction in the frequency and severity of vasomotor symptoms, along with improvements in quality of life. These agents represent a novel non-hormonal therapeutic alternative for menopausal symptom management.

Keywords:Menopause; Vasomotor symptoms; Therapeutics; Neurokinin-1 receptor antagonists; Efficacy; Safety