Real-World Adherence to Nonhormonal Therapies for Menopause-Related Vasomotor Symptoms: A Targeted Literature Review
Author(s)
Catia C Proenca, PhD1, Beata Smela, PhD2, Elzbieta Olewinska, PhD2, Rebecca Dunsmoor-Su, MD, MSCE, FACOG3, Jenifer Sassarini, MBChB PhD MRCOG4.
1Bayer, Basel, Switzerland, 2Clever-Access, Krakow, Poland, 3Seattle Clinical Research Centre, Seattle, WA, USA, 4NHS Greater Glasgow and Clyde, Glasgow, United Kingdom.
1Bayer, Basel, Switzerland, 2Clever-Access, Krakow, Poland, 3Seattle Clinical Research Centre, Seattle, WA, USA, 4NHS Greater Glasgow and Clyde, Glasgow, United Kingdom.
OBJECTIVES: Some guidelines recommend non-hormonal prescription therapies (non-HT; e.g., SSRIs, SNRIs, gabapentin, oxybutynin, clonidine) as an alternative to hormone therapy (HT) to manage menopausal symptoms. A targeted literature review (TLR) was conducted to characterize the burden of menopause. Here, we report adherence to non-HT for menopause-related vasomotor symptoms (VMS).
METHODS: English-language searches were conducted in Medline and Embase databases and grey literature for observational studies of women experiencing menopause-associated VMS. The search included studies published from 2020-2025 in Canada, the USA (from 2023), and select European countries (abstracts from 2022).
RESULTS: We identified three peer-reviewed studies reporting adherence to or discontinuation of non-HT for VMS associated with menopause. A UK study of electronic health records identified that 32.4% of women with a record for VMS diagnosis were initially prescribed non-HT within 12 months of diagnosis; the median treatment duration was 3.9 months. At 2 years, most women had discontinued non-HT, with a reported treatment persistence of 12.5%. In a large multinational study using physician and women’s surveys, the mean treatment duration was longer for women with mild than with moderate-to-severe VMS (24.9 vs. 16.5 months). For women taking SSRI/SNRI only, mean treatment duration was 20.4 (mild) vs. 17.3 (moderate) months; for women taking other non-HT, it was 28.2 (mild) vs. 18.0 (moderate) months. Another multinational study using online surveys found that the most common reason for discontinuation of non-HT (>40%) was lack of improvement of menopausal symptoms. Other common reasons included adverse effects (24%) and concerns about possible long-term risks (21%).
CONCLUSIONS: Overall, real-world discontinuation rates of non-HT to manage VMS associated with menopause are high. The most common reasons for discontinuation included symptoms not improving, adverse events, and safety concerns. This TLR highlights the need for effective treatments to manage menopause-related VMS.
METHODS: English-language searches were conducted in Medline and Embase databases and grey literature for observational studies of women experiencing menopause-associated VMS. The search included studies published from 2020-2025 in Canada, the USA (from 2023), and select European countries (abstracts from 2022).
RESULTS: We identified three peer-reviewed studies reporting adherence to or discontinuation of non-HT for VMS associated with menopause. A UK study of electronic health records identified that 32.4% of women with a record for VMS diagnosis were initially prescribed non-HT within 12 months of diagnosis; the median treatment duration was 3.9 months. At 2 years, most women had discontinued non-HT, with a reported treatment persistence of 12.5%. In a large multinational study using physician and women’s surveys, the mean treatment duration was longer for women with mild than with moderate-to-severe VMS (24.9 vs. 16.5 months). For women taking SSRI/SNRI only, mean treatment duration was 20.4 (mild) vs. 17.3 (moderate) months; for women taking other non-HT, it was 28.2 (mild) vs. 18.0 (moderate) months. Another multinational study using online surveys found that the most common reason for discontinuation of non-HT (>40%) was lack of improvement of menopausal symptoms. Other common reasons included adverse effects (24%) and concerns about possible long-term risks (21%).
CONCLUSIONS: Overall, real-world discontinuation rates of non-HT to manage VMS associated with menopause are high. The most common reasons for discontinuation included symptoms not improving, adverse events, and safety concerns. This TLR highlights the need for effective treatments to manage menopause-related VMS.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
RWD146
Topic
Clinical Outcomes, Patient-Centered Research, Real World Data & Information Systems
Disease
No Additional Disease & Conditions/Specialized Treatment Areas, Reproductive & Sexual Health