A new treatment designed to prevent severe menopausal hot flushes and night sweats is set to become available on the NHS in England, offering a long-awaited alternative for women who cannot take hormone replacement therapy (HRT). The drug, Veoza (fezolinetant), has received approval from the National Institute for Health and Care Excellence (NICE), meaning it can now be prescribed through NHS services for eligible patients.
Health experts say the move represents an important milestone in women’s healthcare, addressing a major gap in treatment options for menopause symptoms that affect millions of women across the UK.
A new option beyond hormone replacement therapy
Menopause symptoms such as hot flushes and night sweats, collectively known as vasomotor symptoms, which affect roughly 70–75% of women during the transition to menopause. These episodes can cause sudden overheating, sweating, sleep disturbance and significant disruption to daily life. For decades, hormone replacement therapy (HRT) has been the most effective medical treatment. However, it is not suitable for all women, particularly those with conditions such as certain cancers, blood-clotting disorders or uncontrolled hypertension.
The approval of fezolinetant offers an alternative pathway. The medication is a non-hormonal daily tablet that targets temperature regulation pathways in the brain. Rather than replacing hormones, it blocks neurokinin-3 receptors involved in the neural signals that trigger hot flushes and night sweats. By interrupting these signals, the drug helps regulate body temperature and reduce the frequency and severity of symptoms.
Evidence from clinical trials
Clinical studies have demonstrated measurable benefits from the treatment. Trials involving women with moderate to severe menopausal symptoms found that the number of hot flushes fell by around 60% after 12 weeks of treatment, compared with about 45 per cent among participants taking a placebo. Participants also reported improvements in sleep quality and reductions in the intensity of symptoms, factors that can significantly affect quality of life during menopause.
NICE concluded that the medicine offers meaningful clinical benefit for patients who cannot use HRT and that it represents cost-effective treatment for the NHS. Approximately 500,000 women in England are expected to be eligible for the therapy under the current criteria.
Safety considerations and monitoring
While the drug has been welcomed as an important new treatment option, regulators emphasise the need for careful monitoring. The Medicines and Healthcare products Regulatory Agency (MHRA) has issued guidance stating that fezolinetant may carry a risk of drug-induced liver injury, although such cases are rare and usually reversible.
As a result, clinicians are advised to check liver function before starting the medication and periodically during treatment. Patients with existing liver disease are generally advised not to use the drug. Common side effects may include abdominal pain, insomnia and diarrhoea, although most clinical trial participants tolerated the treatment well.
NHS leaders welcome new treatment
Healthcare leaders have described the decision as a significant step forward for women’s health. Dr Sue Mann, national clinical director for women’s health at NHS England, said that menopausal symptoms can have a profound impact on everyday life.
She noted that hot flushes and night sweats can disrupt sleep, work productivity and overall wellbeing, adding that the new therapy could help “hundreds of thousands of women better manage their symptoms”. Helen Knight, director of medicines evaluation at NICE, also highlighted the importance of expanding treatment options for patients who cannot take HRT. She said women have long reported difficulty accessing effective non-hormonal therapies, and the approval of fezolinetant addresses a previously unmet clinical need.
Implications for NHS digital health and women’s healthcare
The introduction of fezolinetant comes at a time when the NHS is seeking to strengthen services for women through the Women’s Health Strategy for England, which aims to improve research, diagnosis and treatment across conditions affecting women. Digital health tools may also play a role in identifying patients who could benefit from the new therapy. NHS electronic patient record systems and menopause clinics increasingly use data analytics to track symptom patterns, treatment outcomes and prescribing trends. Experts believe this data-driven approach could help clinicians better personalise menopause care, ensuring that treatments such as fezolinetant are offered to patients most likely to benefit.
A growing focus on menopause care
The approval reflects a broader shift in healthcare policy toward recognising menopause as a major public health issue. The UK has more than 13 million women who are menopausal or perimenopausal, and demand for treatment and workplace support has risen sharply in recent years. For NHS clinicians and policymakers, the arrival of a new non-hormonal therapy marks a significant development in addressing a longstanding treatment gap. While HRT will remain the first-line option for many women, fezolinetant provides a crucial alternative for those who cannot or prefer not to use hormonal therapies. As menopause care becomes an increasingly prominent issue in healthcare policy and digital health innovation, the introduction of Veoza may represent the beginning of a broader wave of targeted therapies designed to improve quality of life for women across the NHS.
