A detailed look at a 1News report comparing the non-hormonal medication Veoza with traditional HRT for treating severe menopausal hot flushes and night sweats.
On September 21, 2026, 1News New Zealand published a detailed report comparing the non-hormonal menopause medicine Veoza with traditional hormone replacement therapy. The analysis by researchers from the University of Melbourne and the Florey Institute of Neuroscience and Mental Health examined clinical data to clarify how targeted neurokinin blockers fit into modern symptom management.
For decades, the standard approach to managing menopausal hot flushes and night sweats has been hormone replacement therapy. This treatment replaces the oestrogen and progesterone lost during the menopausal transition, addressing a broad spectrum of physiological changes ranging from bone density reduction to vaginal dryness. Women who could not safely take systemic hormones because of hormone-sensitive cancers or a history of blood clots were often left with limited medical alternatives. Medical consensus accepted that non-hormonal options were often less effective, leaving many patients to manage severe vasomotor symptoms without targeted pharmaceutical relief.
Vasomotor symptoms affect almost 40 percent of women in the lead-up to menopause, or perimenopause. The transition out of the reproductive years brings a predictable decline in ovarian hormones. Hormone replacement therapy has long been the primary comprehensive strategy for addressing this shift. The 1News report reinforces that hormone therapy remains the more appropriate option when a woman experiences several symptoms linked to oestrogen deficiency.
By treating the underlying hormonal shift, traditional therapy provides systemic support. But a global survey spanning Europe, the United Kingdom, the United States and Japan found that one in ten women with vasomotor symptoms could not take hormone replacement therapy. This gap in care highlighted a clear need for treatments that target hot flushes without altering hormone levels.
The recent 1News report details how Veoza, known generically as fezolinetant, bypasses the hormonal system entirely. Instead of raising oestrogen levels, it directly blocks the neurokinin-3 receptor in the temperature-regulation centre of the brain. This mechanism focuses specifically on neurokinin B signalling from KNDy cells, which becomes overactive when oestrogen levels drop.
To understand this shift, it helps to look at the brain's hypothalamus. The hypothalamus relies on specific nerve cells, known as KNDy cells, to help manage the body's internal thermostat. During the reproductive years, steady oestrogen levels keep these cells functioning normally.
But as oestrogen drops during the menopausal transition, the KNDy cells become overactive. They release excess neurokinin B, which sends false signals to the brain that the body is overheating, triggering a hot flush. Veoza works by blocking the neurokinin-3 receptor, preventing those false signals from registering.
The evidence presented in the report includes several specific findings and updated protocols:
The new class of neurokinin blockers represents a shift in how medicine approaches perimenopause and menopause, but it is not a complete replacement for hormone therapy. The 1News report stresses that Veoza is a highly targeted medicine. It does not directly treat most mood symptoms, vaginal dryness, reduced bone density or other consequences of oestrogen deficiency. Women facing a complex presentation of oestrogen deficiency will likely still find hormone therapy to be the more comprehensive approach.
Furthermore, non-hormonal does not mean risk-free. The prescribing information for Veoza includes strict protocols for liver monitoring. Rare cases of liver injury have been reported, which makes the baseline and scheduled blood tests mandatory during the first nine months of treatment. Commonly reported side effects include headache, nausea, abdominal pain and insomnia.
It is also crucial to recognise that Veoza does not prevent pregnancy. Women who are still menstruating or in the early stages of perimenopause may need to continue using contraception. When building a plan with credible midlife health resources, safety requires clear communication with a prescribing clinician about all current medications, existing health conditions and reproductive status.
Clinical trial evidence currently supports symptom reduction for up to one year. Effectiveness and safety beyond that 12-month period remain areas for continued assessment. The 1News report notes that researchers are actively investigating long-term outcomes, rare adverse effects and how the drug performs in women with complex medical conditions.
The pharmaceutical landscape is also expanding. The report identifies elinzanetant, marketed as Lynkuet, as a newer treatment that targets both the NK1 and NK3 receptors. Approved in September 2025, Lynkuet was evaluated in clinical trials involving more than 1,500 women. These trials reported reductions in vasomotor symptoms and sleep problems, along with quality-of-life improvements.
The 1News analysis notes Lynkuet appears to have a better liver-safety profile than Veoza, though ongoing monitoring will clarify its long-term safety. Interestingly, the mechanism behind neurokinin blockers is not limited to female reproductive transitions. Veoza is currently being investigated for hot flushes associated with prostate cancer treatments. Up to 80 percent of men receiving androgen-deprivation therapy experience these sudden temperature shifts, suggesting that temperature-regulation pathways operate in comparable ways across different patient populations.
Even with clinical approval, gaining access to new medications can be complicated by regional healthcare policies. Regulatory summaries note the United States Food and Drug Administration approved Veoza in May 2023. It received approval for use in Australia in March 2024, with a standard dose of one 45 milligram tablet daily. However, the report notes that it was not subsidised through Australia’s Pharmaceutical Benefits Scheme.
This leaves Australian patients with an estimated monthly prescription cost of 75 to 80 Australian dollars. Availability is even more restricted in some regions. At the time the 1News report was published, Veoza was neither registered by Medsafe nor funded by Pharmac in New Zealand. This patchwork of regulatory approval and funding means that many women cannot easily access the drug, regardless of their clinical suitability.
If severe night sweats and hot flushes are your primary concern, asking a prescriber about a targeted non-hormonal medication is a logical first step. This conversation is especially important if you have a medical history that makes traditional hormone therapy unsuitable. Before starting a medication like Veoza, you must discuss the mandatory liver testing schedule. Regulatory guidelines mandate baseline blood tests followed by monthly checks during the first three months of treatment, plus additional tests at months six and nine.
You should also ask your prescriber or pharmacist to review every medication you currently take. Because fluvoxamine is explicitly identified as an interaction risk, full disclosure of all antidepressants and over-the-counter supplements is critical for your safety. If you are also experiencing painful sex, significant mood changes or bone density concerns, you must discuss separate treatments for those issues. A neurokinin blocker will not replace the oestrogen required to maintain tissue health in other parts of the body.
Navigating treatment choices for hot flushes requires a realistic understanding of what these medications can achieve. The trial data shows substantial average reductions rather than complete symptom elimination. A significant placebo response was also observed in the trials. Women taking the inactive pill saw their symptoms decrease noticeably, which is a clinically important factor when setting expectations.
The most useful goal for patients considering Veoza is likely fewer or less disruptive episodes, rather than a guarantee of becoming completely symptom-free. Tracking episode frequency, daytime function, sleep disruption and overall quality of life can help you assess whether the treatment provides a meaningful benefit. Maintaining a record of these changes supports better conversations with your prescribing clinician.
For those managing broad changes in strength, body composition and metabolism, a medication focused purely on temperature regulation will not address systemic physical shifts. Existing evidence has primarily evaluated Veoza as an alternative to hormone therapy rather than a complementary treatment. Whether it can be safely combined with systemic hormones remains an individual prescribing question rather than a broad clinical recommendation.
The introduction of targeted therapies changes how clinicians and patients discuss midlife physiology. Historically, treating vasomotor symptoms meant accepting systemic hormonal changes, which did not suit every patient. By separating temperature regulation from oestrogen replacement, women have more specific tools for managing their physical comfort.
This development is particularly relevant for individuals navigating concurrent health challenges. Women who cannot use hormone therapy because of side effects or health conditions now have a clinically validated option to discuss. It allows them to focus on stabilizing their daily routine and preserving their sleep quality. Sleep disruption, driven by severe night sweats, frequently cascades into fatigue, affecting daytime energy and emotional resilience.
When women can manage severe temperature fluctuations effectively, they often find it easier to focus on other aspects of their wellbeing. Maintaining a consistent routine for nutrition and weight management is much simpler when your sleep is not constantly interrupted. Addressing one highly disruptive symptom can create the physical and mental space needed to focus on overall capability. It is a reminder that midlife health strategies should be tailored to the exact problems a woman is experiencing, rather than relying on a single uniform approach.
The clinical confirmation of neurokinin blockers will shift menopause care from a uniform hormonal strategy toward a more precise, symptom-specific approach for women who cannot or choose not to use systemic hormones.
While a trusted pharmacist or prescribing clinician handles the daily monitoring of new hot flush medications, understanding how these targeted treatments fit into a broader midlife strategy is simpler when Refemina evaluates the clinical research. We counter health content that treats every problem as a supplement, hormone or weight-loss opportunity, translating credible evidence into clear adult guidance so you can make informed choices without wellness hype.
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