Nonhormonal Therapies Transform Hot Flash Treatment in Menopause | HCPLive

In 2025, major shifts to the landscape of non-hormonal therapies available for treating vasomotor symptoms (VMS) in postmenopausal women were reported, the most recent being the FDA approval of elinzanetant (Lynkuet) in this population on October 24, 2025.1

Elinzanetant, a neurokinin receptor antagonist, represents a method of treatment which, according to JoAnn V. Pinkerton, MD, division director of midlife health at UVA Health, has begun to reshape the VMS landscape.2 Thermoregulatory instability during menopause has been linked to overactivity in certain hypothalamic neurons caused by declining estrogen levels.

Risks associated with hormonal therapies have previously been reported to patients through boxed warnings on the products’ labeling.4 In the Women’s Health Initiative (WHI) trials, increased risks of stroke and breast cancer were reported in patients receiving menopausal hormonal therapy (MHT).

This revelation led to class-wide boxed warnings being added to MHT starting in 2003. However, the FDA noted that WHI participants had an increased age relative to the general population receiving therapy for hot flash relief, increasing their baseline risks.4

Compared to the mean age of 51 years in patients starting MHT, dementia findings in the WHI were based on women aged 65 to 79 years. The primary version of hormone therapy has also changed since this data was published, from oral conjugated equine estrogens plus medroxyprogesterone acetate to versions with transdermal estradiol, which reduces venous thrombosis risk.4Based on this information, the FDA announced actions to revise safety labelling for MHT on November 10, 2025. These changes included:4

• Removing warnings about cardiovascular disease, breast cancer, and dementia
• Removing most references to endometrial cancer
• Removing recommendations to use the lowest dose for the shortest duration

Currently, warnings about breast cancer risk remain for labeling outside of boxed warnings for systemic therapy. Further research is needed to understand the link between MHT and breast cancer.4

“It's important to note that we need more data to make up for the dearth of research in this domain and until we better understand the full impact of MHT on breast cancer risk, women with a personal history of breast cancer remain ineligible for MHT,” said Nora Lansen, MD, chief medical officer at Elektra Health.4

Clinical Evidence Supporting Fezolinetant

During the period of boxed warnings for hormonal options, multiple nonhormonal treatments rose in the vasomotor symptom landscape. At the 2023 ACOG Annual Clinical & Scientific Meeting, Genevieve Neal-Perry, MD, PhD, professor at the University of North Carolina at Chapel Hill, presented data regarding the safety and efficacy of fezolinetant.3

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Nonhormonal Therapies Transform Hot Flash Treatment in Menopause | HCPLive

(1) THE DIGITAL AGE DILEMMA | Blue Light interrupts Circadian Sleep Cycle

(1) THE DIGITAL AGE DILEMMA | LinkedIn

In today’s hyper-connected world, screens are unavoidable. From office desktops and smartphones to tablets and TVs, we are constantly absorbing information through digital devices. But this comes at a price—digital eye strain, also known as computer vision syndrome, is a growing health concern affecting professionals worldwide. One of the biggest culprits is the Blue light.

WHAT IS BLUE LIGHT? AND WHY DOES IT MATTER?

Blue light is a high-energy visible (HEV) light emitted by screens and artificial lightingBlue light is a high-energy visible (HEV) light emitted by screens and artificial lighting. While natural blue light from the sun regulates our circadian rhythm (sleep-wake cycle), prolonged exposure to artificial blue light—especially at night— can disrupt our sleep, cause eye fatigue, and even cause changes in vision over time.

HOW BLUE LIGHT AFFECTS YOUR HEALTH ?

Eye Strain & Fatigue: Extended screen time forces our eyes to work harder, leading to dryness, irritation, and blurred vision. light exposure can trigger migraines and tension headaches, especially in individuals prone to light sensitivity.

Disrupted Sleep Patterns: Screens before bedtime suppress melatonin production, making it harder to fall asleep and affecting overall sleep quality.Potential Long-Term Damage: Studies suggest that too much blue light can strain your eyes and may slowly harm your vision over time, especially as you get older.

WHY WORKING PROFESSIONALS ARE AT HIGHER RISK ?

If you spend hours in front of a screen for work, you’re especially vulnerable to blue light exposure and its consequences. Reports indicate that an average office worker spends 6-9 hours a day staring at a screen. Combined with poor ergonomics, artificial lighting, and minimal breaks, this creates a perfect storm for digital eye strain.

Some common warning signs include:

Frequent dry or irritated eyes

Increased sensitivity to light

Difficulty focusing, especially in the evening

Continuous focus at a close distance can weaken the eye’s ability to shift focus to far objects, causing temporary or long-term blurred distance vision.

Trouble falling or staying asleep

HOW TO PROTECT YOUR EYES WITHOUT QUITTING SCREENS

Since ditching screens isn’t an option for most professionals, here are practical, science-backed solutions to reduce eye strain and blue light exposure:

Follow the 20-20-20 Rule Every 20 minutes, look at something 20 feet away for 20 seconds to relax your eye muscles.

Adjust Screen Settings Use “Night Mode” or “Blue Light Filter” on your devices to reduce HEV light exposure, especially in the evening.

Wear Blue Light Blocking Glasses Invest in blue light filtering glasses, which reduce the amount of HEV light reaching your retina.

Blink More & Stay Hydrated Blinking keeps your eyes moist. When focusing on a screen, we blink 50% less than normal, leading to dryness.

Optimize Your Workspace Position your screen an arm’s length away and slightly below eye level to minimize strain. Use anti-glare screens or a matte screen protector.

Limit Screen Use Before Bed Avoid screens 1-2 hours before sleep or use apps like f.lux or Night Shift to reduce blue light emission.

DIGITAL WELLNESS IS KEY

Technology is essential, but our health should be a priority. By making small adjustments, you can significantly reduce digital eye strain and protect your vision, productivity, and well-being in the long run

The Ghosts of Christmas Past, Present, and Future

Visit 3 Ghosts right there in the exam room.

👻 THE GHOST OF PATIENT PAST We time-travel back to 7th grade. I ask them to visualize themselves at that age—when the world was their oyster. The kid who wanted to be an astronaut, an athlete, or an artist. I ask: "If that 12-year-old walked in here and saw you today—on 12 medications, immobile, and hurting—what would they say?" This isn't about shame; it's about Cognitive Dissonance. It reconnects them with their original spark and highlights the drift between who they wanted to be and who they became.

👻 THE GHOST OF PATIENT PRESENT This is the reality audit. Most patients view themselves as passive passengers in a broken vehicle. I flip the script. We look at the metabolic bankruptcy happening right now. It demands they take a hostile takeover of their own biology.

👻 THE GHOST OF PATIENT FUTURE This is the binary choice. I force a visualization of two distinct timelines 10 years from now.

Timeline A: You stay on this road. You are wheelchair-bound, dependent on nursing care, or gone.

Timeline B: You pivot today. You are mobile, vibrant, and playing with your grandkids. It is a stark, visceral fork in the road.

THE VERDICT: WAKING UP THE CEO Why do I do this? Because these three ghosts serve one purpose: To wake up the CEO of your own health.

You cannot outsource your biology to a doctor, an insurance company, or a spouse. You are the Chief Executive of your body. The Ghost of the Past provides your history; the Ghost of the Present provides your balance sheet; and the Ghost of the Future provides your forecast.

But only the CEO can make the executive decision to change direction.

I want to hear from you: As a patient, would this "Scrooge" approach motivate you to change, or would you find it too intense? And to my fellow providers—how do you break through the wall of denial when data fails?

Better Than DoorDash or UberEats

 

Why Are Physicians Starting Businesses

Trends in physician entrepreneurshp:

1. New business models
2. Participation in non-clinical roles
3. AI edupreneurship
4. Women's health and femtech
5. Medical education, training, and development reform
6. The return of private practice
7. Direct payment care instead of only direct primary care
8. New generational attitudes about medicine as a job
9. Demographic change
10. The evolving medical cybernervous system
11. Patient entrepreneurship
12. Careers in entrepreneurial finance and investing

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