The role of neurokinin B in the pathophysiological mechanisms of vasomotor symptoms and sleep disturbances in postmenopausal women

Objective. To carry out a systematic analysis of the serum level of neurokinin B (NKB) in women of different age periods and in those with and without vasomotor symptoms and sleep disturbances. To assess the time course of changes in the level of NKB during menopausal hormone therapy (MHT). Subjects and methods. The investigation enrolled 50 postmenopausal women and 30 reproductive-aged women having a regular menstrual cycle. The patients were divided into 3 groups: 1) 25 postmenopausal patients with vasomotor symptoms and sleep disturbances; 2) 25 postmenopausal patients without vasomotor symptoms and sleep disturbances. A control group (Group 3) included 30 reproductive-aged women having a regular menstrual cycle. Group 1 received MHT. The dynamics of menopausal symptoms (Greene Climacteric Scale), a subjective sleep rating scale, and NKB levels were assessed after 12 weeks of therapy. Results. There was a significant increase in serum NKB levels in postmenopausal women compared with the controls. In postmenopausal women with sleep disturbances and vasomotor symptoms, NKB levels were statistically significantly higher than in women without the above symptoms. A strong relationship was established between the level of NKB and the severity of menopausal syndrome. There was a signif icant decrease in the severity of menopausal symptoms after 12 weeks of MHT, which was accompanied by a 3.2-fold decrease in NKB levels. Conclusion. The findings suggest that the activation of KNDy neurons and the increased secretion of NKB play a possible role in the pathogenesis of sleep disturbances and vasomotor symptoms in postmenopausal women.

menopausal syndrome, sleep disturbances, hot flashes, neurokinin B (NKB), KNDy neurons, triggers of vasomotor symptoms