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ISO2026: Comprehensive Management of Menopause: Non-Hormonal Options
This session reviews the nonhormonal management of menopausal vasomotor symptoms, beginning with the symptom burden of menopause and the risk factors and duration of vasomotor symptoms across racial and ethnic groups. It surveys nonpharmacologic approaches, including cognitive behavioral therapy, clinical hypnosis, acupuncture, and exercise and yoga, and identifies where the evidence does and does not support benefit for hot flashes. It reviews repurposed agents used off label, including selective serotonin and serotonin norepinephrine reuptake inhibitors, gabapentin, and oxybutynin, and the FDA approved nonhormonal options of low dose paroxetine and the neurokinin receptor antagonists fezolinetant and elinzanetant. The session explains the kisspeptin neurokinin B dynorphin neuronal mechanism that underlies these targeted therapies and presents the efficacy, safety, and bone outcomes from their pivotal trials. It closes with the management of vasomotor symptoms in women with breast cancer on endocrine therapy.
Target Audience
This continuing education activity is intended for use by health professionals who participate in the care of patients at risk for or suffering from osteoporosis, in the areas of primary care, endocrinology, geriatrics, gynecology, internal, obstetrics, orthopedics, osteopathy, pediatrics, physiatry, radiology, rheumatology and physical therapy.
This includes physicians, nurse practitioners, registered nurses, pharmacists, physician assistants, technologists, researchers, public health professionals and health educators with an interest in osteoporosis and bone health.
Learning Objectives
Upon completion of this session, participants will be able to:
1. Describe the symptom burden of menopause and the risk factors associated with the development and duration of vasomotor symptoms across racial and ethnic groups.
2. Evaluate the evidence for nonpharmacologic approaches to vasomotor symptoms, including cognitive behavioral therapy, clinical hypnosis, acupuncture, exercise, and yoga, distinguishing those with demonstrated benefit for hot flashes from those without.
3. Compare the repurposed off label agents and the FDA approved nonhormonal pharmacologic options for vasomotor symptoms, including selective serotonin and serotonin norepinephrine reuptake inhibitors, gabapentin, oxybutynin, low dose paroxetine, fezolinetant, and elinzanetant.
4. Explain the kisspeptin neurokinin B dynorphin mechanism of vasomotor symptoms and the way neurokinin 3 and dual neurokinin 1 and 3 receptor antagonism moderates thermoregulatory activity, including the efficacy, safety, and bone outcomes observed in pivotal trials.
5. Select appropriate nonhormonal treatment for women with vasomotor symptoms in whom hormone therapy is contraindicated or undesired, including women with estrogen sensitive breast cancer on endocrine therapy.
Name of Individual | Individual's Role(s) in Activity | Name of Ineligible Company(s) | Nature of Relationship(s) |
JoAnn V. Pinkerton, MD, FACOG, MSCP | Speaker | N/A | N/A |
| Amy Mitchell, MSN, FNP-C | Planner/Accredited Provider Program Director & Content Expert | Amgen & Radius Health | Speaker’s Bureau, Scientific Advisory Board, Consulting |
Ami Patel | BHOF Staff, Vice President of Science & Education | N/A | N/A |
Andrea Medeiros | BHOF Staff, Vice President of Public Health & Policy | N/A | N/A |
Disclosures:
During this lecture Dr. JoAnn Pinkerton may mention the use of medications for both U.S. Food and Drug Administration (FDA)-approved and non-FDA-approved indications.
Past Grant Research support: PI and National lead for Bayer Oasis 2 Phase 3 Clinical Trial;- Fees to UVA
Consultant- Bayer HealthCare Pharmaceuticals Inc- fees to UVA and self, Pfizer
Consultant: independent consultant to Merck, Up to Date, Medscape
Accreditation Statement
The Bone Health and Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The Bone Health and Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.
CME Program Eligibility
Method of Participation in the Learning Process: Clinician learners will view and analyze the subject matter, conduct additional informal research through related internet searches on the subject matter, and complete a post-test assessment of knowledge and skills gained as a result of the activity.
After participating in this activity, the reader has the option of taking an evaluation for this activity. It is estimated it will take 0.75 hour(s) to complete the reading and take the evaluation. Continuing education credit will be available for two years from the date of publication.
Disclosure of Commercial Support
It is the policy of the Bone Health & Osteoporosis Foundation (BHOF) to ensure balance, independence, objectivity, and scientific rigor in all its sponsored publications and programs. BHOF requires the disclosure of the existence of any significant financial interest or any other relationship the sponsor, Editorial Board or Guest Contributors have with the manufacturer(s) of any commercial product(s) discussed in an educational presentation. All authors and contributors to this continuing education activity have disclosed any real or apparent interest that may have direct bearing on the subject matter of this program.
Please be advised that BHOF’s accreditation status with ACCME and ANCC does not imply endorsement by BHOF, ACCME or ANCC of any commercial products displayed in conjunction with this activity or endorsement of any point of view.
Refund Policy
BHOF offers no returns or refunds on online internet CME activities purchased through our store. All sales are final. Meeting and workshop registrations will be refunded in accordance with the cancellation policy of the meeting and/or workshop, as outlined at registration.
Available Credit
- 0.75 AMA PRA Category 1 Credit™The National Osteoporosis Foundation is an approved Accreditation Council for Continuing Medical Education (ACCME) accredited CME provider through March 2023. ACCME accreditation accelerates learning, change and improvement in the field of osteoporosis. The National Osteoporosis Foundation is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The National Osteoporosis Foundation designates educational activities for AMA PRA Category 1 Credit™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
- 0.75 ANCCThe mission of the American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), is to promote excellence in nursing and health care globally through credentialing programs. The National Osteoporosis Foundation is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation. The National Osteoporosis Foundation designates educational activities for continuing nursing education credit(s).
- 0.75 Participation
- 0.75 Participation/AttendanceA certificate of attendance will be provided to all other attending healthcare professionals. Nurse practitioners and physician assistants may request AMA PRA Category 1 Credit(s)™ certificate of participation. Please refer to your provider to determine whether this program will qualify for other categories of continuing education credits. The American Academy of Physician Assistants (AAPA) also accepts educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by the Accreditation Council for Continuing Education (ACCME).