Non-Hormonal Menopause Relief

Hot flashes that hijack your day and wreck your sleep are more than a nuisance—they’re a brain‑level problem with real solutions. Speaking of Women's Health Podcast host Dr. Holly Thacker sits down with Dr. Nayoung Sung from Cleveland Clinic’s Center for Specialized Women’s Health to unpack a new non‑hormonal therapy, Lynkuet® (elinzanetant).

For listeners weighing options, Dr. Sung and Dr. Thacker lay out who benefits most from non‑hormonal care—those with clotting risks, estrogen‑sensitive cancers, or simple preference to avoid hormones—and where low‑dose paroxetine, venlafaxine, gabapentin, and oxybutynin still fit when personalized thoughtfully.

Relief should also respect the rest of your health. We dive into sexual wellness with local vaginal estrogen or DHEA for tissue comfort, and we zoom out to the metabolic picture: abdominal weight gain, high triglycerides, insulin resistance, and inflammation that magnify heat, pain, and brain fog. Dr. Sung shares early findings on omega‑3 and omega‑6 balance, ferritin, zinc, and CRP—and how small diet shifts and targeted testing can support clearer thinking and steadier energy alongside symptom control.

If you’re searching for safe, swift, and truly personalized menopause care, this conversation delivers. Subscribe, leave a review, and share this episode with someone who deserves cooler nights and brighter days—what question do you want us to tackle next?

Transcript

Welcome And Guest Background

Dr. \ 0:00

Welcome to the Speaking of Women's Health podcast. I'm your host, Dr. Holly Thacker, back in the Sunflower House for another new podcast on Speaking of Women's Health. And today we have a special guest. Dr. Naeong Sung is our senior specialized women's health at the Center for Specialized Women's Health and the OBGYN Institute at Cleveland Clinic. And today we're going to dive into a really important topic for women navigating menopause, which is managing moderate to severe hot flashes. And Dr. Nang Sung uh is going to discuss a new option that was just FDA approved at the end of 2025. Before we start this podcast interview, I want to tell you just a little bit about her very impressive background. As I mentioned, she's a senior fellow uh in our Center for Specialized Women's Health. And she graduated uh from the Shu Hung Young University College of Medicine in South Korea in OBGYN. And then she uh came to the United States and she trained in OBGYN, reproductive endocrinology and infertility. She did that at South Korea, and then she came to the United States and did a reproductive immunology fellowship at the Rosalind Franklin University in Chicago. And she met her husband in Chicago. He was advertising for a singer, so she met him in his band. And she was singing in his band. And she decided that she was going to marry him and uh stay in America. And so then she uh did a family medicine residency in Southern California, and then came to Cleveland to do her third fellowship after two residencies. So she is so well trained, and last year she got her American citizenship, and she and her husband have uh an adorable young son, Aiden. So welcome, Dr. Sung. Thank you so much introduction, Dr. Dr. Thaker. So Linquet or Ellizena Tent, um, it's a prescription and it's a non-hormonal medication. And when I started this podcast in early 2023, three years ago in season one, I actually had several CME continuing medical education podcasts for physicians and clinicians prescribing non-hormonal options. And uh back then we were expecting uh phessalinitant VOSA, which was approved in May of 2023. So it was really nice two and a half years later to get another option. And so when we talk about moderate to severe vasomotor symptoms, we're talking about things like hot flashes and night sweats that interfere with daily life uh and really affect um how a woman feels and how she she functions. So moderate, um moderate symptoms can also cause someone to feel exhausted. Uh and if it affects sleep, it's really a problem. But unlike hormone therapy, these non-hormonal options don't replace estrogen, and we have lots of podcasts on menopause and hormone therapy. But it's important to understand the physiology that these changes at midlife in perimenopause when the levels go up and down, and then in postmenopause, where there's really no measurable estrogen levels, that certain neurons in the brain called candy, Kn D Y, not candy like the sugar, um, they become very overactive. And Linquet blocks NK1 and NK3 receptors involved in that pathway. Whereas um VIOSA just blocks one. So, in short, it is a really exciting uh and new therapeutic option. So I wanted to talk to Dr. Sung today about who do you think can really benefit from this new therapy?

SPEAKER_01 4:44

Well, so now it's really great to have two and these two FD approved one to manage the half fleshes. So the link, yeah, as Dr. Thicker explained, the linkquid is non-hormonal if they approved medication. So that's dual blocker. So as she mentioned, urokine receptor one and three receptor blocker. Comparing to the VIOSA, that one is three urokin and three receptor blocker. So so far their data showed these medications better, well, so both of them really good medication, but controlling managing the half flesh is on top of that, so more better effect on insomnia with the link quest. The mechanism explained the possibility, well, because vasomortal symptoms definitely can affect the sleep condition. But when we take a look at data, who has vesimeral symptom? Two-thirds has sleep disorder. Who does not have even who does not have vesymore symptom? Yes, we can stick 30 more than 30% women will have insomnia, so because of the both of them very important. So this is really good information, possibly that neurokinin receptor one is more involved in sleep condition. So link white can control vesimer symptoms and better control for insomnia. So definitely who cannot uh take estrogen containing one, like an ideal candidate, for example, who has history estrogen receptor condition or actively getting breast cancer treatment like that, those patients not a good candidate candidate for hormonal treatment. Personal history like that, or families who really fear to start estrogen-containing hormone, those populations really uh can get benefited with a non-hormonal option. So because now we have three FDA approved ones for managing the half-flesh shit. So one, as I mentioned, the frigillinatine, second is illignitine, new medication linguette, and third one is antidepressant medication paroxetine. So I think this is really good. Even we have some more off-label medication to mitigate some more symptoms, but FD approved one now we have three. That is really good options we can try. Also, even who is not uh indicated that uh not good incandidate for hormonal treatment, and and also some people just feel uncomfortable with hormonal treatment. Also, those populations definitely can try this non-hormonal option to manage their vesmotor symptoms.

Dr. \ 7:05

Women who might really want to consider something non-hormonal, certainly if they have some of the rare few contraindications to hormones, although, really, there's in my um vast clinical experience really not that many absolute contraindications. But there are just some women who just don't feel as good on hormones, they have more breast tenderness, uh, they don't want to have to deal with possible bleeding and spotting if they have a uterus. Um, so it's just so nice to have other options. Um, so so Dr. Sung, do you want to talk a little bit about some of the clinical trials and what some of the benefits are and how long it takes and how women take the medication?

SPEAKER_01 7:53

Okay, so the link so that is two tablets, so 66 is a total 120 milligram. So they recommend taking night. And their study showed where the patients started taking the medication, just within one week they were able to see the improvement. And when they uh observed their improvement up to kind of up to four weeks, they feel like patients felt like their condition back to normal. So they kind of quick response. The they uh monitor up to 12 weeks, that much side effect, and majority patients compared to placebo group to control um the patient took the medication, see really significant improvement with the medication on sleep and also vasomotor symptom. Very quick response with the medication.

Dr. \ 8:42

Okay, that's that's excellent. Because how long do you tell your patients when they start on menopausal hormones how long it takes for them to get relief of symptoms?

SPEAKER_01 8:50

To f to get full kind of response, usually we spend any weight up to three months, like 12 weeks. But also, some people can feel it in four weeks, they can feel some differences, but usually it takes time. But this new medication is we can see the very quick response with the medication. Excellent, excellent.

Dr. \ 9:10

Um, and so what do you tell your patients are are the risks when they're taking Linquet?

SPEAKER_01 9:17

Well, this so far this one does not show much kind of side effects, but uh because a different mechanism is the fajalinatin, the fioza, because a little concerned part is liver enzyme. So with the fajalinatin, we know there's some some cases we saw really elevated liver enzyme. That was not fatal, it that was transient, it back to normal when the patient started the medication. Even those different mechanisms we little concerned about the liver condition. So who has an active liver condition? We would not recommend start that one. And uh even there is no data showed the evil enzyme was elevated with linked enginitane, still we recommend check the liver enzyme, the baseline, and repeat in three months. There is no really uh no contraindication who cannot use this one.

Dr. \ 10:10

So um tell us uh a little bit about comparing linquet to VIOSA and the monitoring of the liver functions and how that kind of compares and how the dosing compares.

Safety And Liver Monitoring

SPEAKER_01 10:24

Yeah, so both the medication targeting the kidney neuron, so targeting the uryne receptor. So that is kind of the same, but okay, the difference is single receptor blocker and dual receptor blockers, so that's big differences, and um the half-life a little different. So the views are the frigillinitine kind of um I remember like around six to nine hours, but the linkage a little longer half-life, that is kind of almost 40 hours. So that could be different, and the liver enzyme, just as you mentioned, the liver enzyme tracking at baseline and three months for illingitane for VOs or the fetrolinatine, we check the first three months every month, and then we repair it in a six months and nine months. That is important to monitor the liver enzyme because of the uh some cases reported.

Dr. \ 11:15

Yeah, very rare cases. And then do you want to talk about the dosing comparisons? Uh, like Linquet is two tablets daily as opposed to VOSA one, so you might have some dosing flexibility if a woman is on other medications that go through the liver and affect the metabolism.

SPEAKER_01 11:33

Right, so the the new medication it's lunatic two tablets. So even the recommended take two tablets at night time, but maybe uh who is who knows who sent feel sensitive to medication, maybe we can start with one tablet. So not many side effects, but some people can feel dizziness, some feel sleepiness because of their recommended at night, and maybe we can start with one tablet and can increase the two tablet. But the fiddle linatant is one one dose, and but they recommend if the patient has a lot of symptoms at night, yes, take a night. If the patient has a lot of symptoms in the morning, you can take them in the morning. So there's some flexibility with the fiddlingatin taking medication, but for new medication in the genitane, they recommended taking night.

Comparing Linquet And VEOZAH

Drug Interactions And Flexibility

Dr. \ 12:21

And can you talk about maybe some of the other medications that might affect the metabolism of these candy neuron inhibitors? Let's see. So, like women that are on Topamax, which is a seizure medicine, and some women take that for appetite suppressants or for migraine headaches, they may need a lower dose. So, I guess if you go with linquet, you have that ability as opposed to VOSA. Uh, certainly in these studies, women did drink caffeine and some women did smoke, and those things can also affect liver metabolism, but we don't really do dosage changes. Um, certainly there are some cardiac medications and um other medicines. So, if a woman happens to be on a lot of medications, it's probably a good idea for her uh physician to kind of look through uh and check for any kind of drug-drug interactions or metabolic changes. So that's why I think I might favor link quit uh in a woman who's on a lot of different medications that are hepatically metabolized just to have that flexibility. Um now, you have been listening to the Speaking of Women's Health Podcast. I'm your host, Dr. Holly Thacker, and we are in the Sunflower House, and it is season four, and we are talking about non-hormonal FDA-approved options for hot flashes. And now, of course, we're finally living in the era where all these boxed warnings um scaring women off for decades have been lifted by the FDI FDA related to menopausal hormones. Certainly with oral hormones, there still remains the risk of venous thromboembolism. And so for women with inherited coagulopathies, histories of blood clots, cardiovascular disease, um, we sometimes can use transdermal hormones and other things, so it's not like it's a hundred percent absolute contraindication. But for women in the acute throes of clotting issues, cardiovascular issues, active estrogen positive, breast cancer, uh, women with a rare condition of lymphoangiomatosis, where any estrogen feeds the growth of these tumors in the lungs. It is a godsend to have these non-hormonal options. Dr. Sung has talked about VIOSA, which we've had for over two and a half years, almost three years, uh phaseolitant, which is dosed once a day, uh, and we have good safety data on it, but does need some regular liver function checks, especially in the first year, particularly the first six months. And now we have Lincuette, which is L-lazenotent, which is two tablets daily, um, still need some liver function testing, but not as much. And then the first non-hormonal therapy that was approved is an uber low dose of peroxetine called Brisdel, which is not an antidepressant dose. Um, the antidepressant doses can cause sexual dysfunction and weight gain. Um, and again, all these options that we're talking about are in post-menopausal women, not women that be can can become pregnant. And that's very important to emphasize. Um, when I have fellows and other clinicians who rotate with us through our mini fellowship and menopause, I always emphasize you need to get that diagnosis of menopause. Uh, you can't just say it's menopausal symptoms and we're gonna treat them the same way because ovarian function and um the chance potentially of pregnancy, even if somebody has a tubal ligation or there's no chance of pregnancy, you still want to date the age of menopause. That is just uh very important uh for a number of reasons, and you cannot go on chronologic age, that is for sure. Uh so Dr. Sung, do you want to talk about some of the other off-label non-FDA approved options? And we've physicians certainly for years have prescribed medicines that aren't always on label because to get on label there has to be be done certain amount of research trials, but through experience and through understanding biology and the mechanisms of action, we have used off-label medications in many conditions for years. So, do you want to talk about those groups of medications?

Hormones, Risks, And Contraindications

SPEAKER_01 16:54

Yes, so because there are separate mechanisms we can explain vasomoral symptoms. So, yes, we know the esters are really important, what's going on and what can how it can affect our brain function. That is mean because as I mentioned, the neural medication targeting specific lesions like a kidney neuron, but also our the vasomoral symptom, how flesh is nice, but it can be explained different mechanisms like a serotonin condition and there's a gobber condition and also other kind of neuroendocrine hormones is involved. Because of that, she mentioned the paroxin, that is SSRI. That is also means related to serotonin condition in our brain. So when we were able to when we use that medication, we are able to see the improvement of how flesh is like that. That is SSLRI, but also SNRI, so serotonin and neuroadhyndrome. So neuro uh that can affect vasomort symptoms. So neuromed like a phenophysin, or phenophilicin, this is categorized as SNRI. Those medications can improve under antipersonic uh category, but still, when we use that one, we were able to see the improvement of vasomotor symptoms. That is one category when we explained the off-label managing medication for half fleshes, and second category we explained about kind of anti-seizure medication, gamma pentin. So gamma patent is affecting our neurological signal. So, because of that, then sometimes we use that one for who has nerve-related kind of pain. But also, when we use that one for half fleshes, we can see the improvement with the dose. Every medication has some side effects and benefit, but because of that, based on dose, we can pick which one is good. And third category is oxyblutin. Usually that medication is used for overactive bladder condition, but that one is involved for acetycholine and miscarinic receptor. Those maybe can is involved, those are involved vasomotor symptoms. So the even bladder medication, but when we use for vasomotal symptom patients, we can see the improvement. So because of the re we can see the improvement, but it's not approved by FTA, so we said OP label, but definitely we can try, we have some options.

Off‑Label Options Beyond FDA Picks

Dr. \ 19:12

So you talked about the N uh SRIs, which are the uh serotonin norepinephrine reuptake with the reptinate and uh low dose uh venlifaxine affects her in very low doses can really reset that thermostat. If you use standard doses for anxiety or depression, it doesn't help the hot flashes, but it helps the mood. So the active metabolite of venlofaxine is desvenlifaxine or pristeque. And so I find prestique off-label 50 milligrams daily helpful at mood and vasomotor symptoms, and the NSRI sometimes can help with pain type syndromes as well, like migraines. The class of anticonvulsants like um gabapentin, neurontin, pregaballin, lyrica, in many states those are considered controlled drugs. Um, so there has to be some more monitoring, although I think the addictive potential is not generally for most people particularly great, but it's always important for patients to be honest with their physician or nurse practitioner about if they've had any substance problems. Uh we had a podcast earlier in 2026 on peripheral neuropathy, and that can be very painful. So, we expert menopause physicians, we like to look at patients for why they're seeing us, what their stage in menopause is, do they have vasomotor symptoms or not? Uh have they lost bone or not? And we have so many podcasts on bone health. Uh, do they have genitourinary symptoms? So if you're seeing a woman who's got overactive bladder and you've taken away the bladder irritants, you've given her maybe local vaginal estrogen or DHEA, and she doesn't want to or can't take hormones but still has overactive bladder, then oxybutanin might be a good idea, assuming she doesn't have acute angle glaucoma or some other issues where the anticholinergic medications wouldn't work. A lot of these off-label medicines, though, seem to have more side effects than VIOSA or Linquet. I mean, that's been my clinical experience. I don't know how is it how has your clinical experience been?

SPEAKER_01 21:35

Well, for first of all, like SSNRI, SNRI, sometimes we can see definitely it can affect a little bit of sexual function. So because during the perimenopause menopause, a lot of patients also complain of sexual function issues. On top of that, this medication, these medications can affect a little bit of sexual health because of that, also as Dr. Theker mentioned, it's really important what kind of condition they already have. So based on the maybe the patient that they have some low lipidosexual functionation, maybe uh we will pick different category of medications. So that is SSRIs and RI.

Sexual Health And Vaginal Therapies

Dr. \ 22:10

I think the SSRIs, particularly like full strength peroxetine as opposed to the ultra-low dose of it, um prozac, fluoxetine, surtraline, zoloft, um they can certainly affect the ability uh to climax. And so, generally speaking, hormonal therapy improves blood flow to the genitals and generally helps sexual function, even though it may not be a specific treatment for hypoactive sexual desire disorder, low libido. Um, if women are on non-hormonal options, they're not getting the local treatment for the vagina. And most women, even breast cancer survivors, um, after enough years have passed, depending on the stage of endometrial cancer, can use vaginal estrogen. And for those women who can't use vaginal estrogen, vaginal DHEA in the form of intrarosa is commercially available. And of course, in our practice, we frequently compound a higher strength, a 1% 13 milligram suppository of DHEA, which does boost estrogen and testosterone just at the genital level, doesn't affect the uterus, doesn't get into the bloodstream. So that's a really nice option. Like when I see women who have just been diagnosed with an aggressive estrogen-positive breast cancer, they're obviously very upset, you know, they're maybe taken off their hormone therapy, or if they haven't been on hormone therapy, if they're going to have to be put into medical menopause, they're obviously very anxious about the hot flashes, their sexual function, their skin and hair, their bone, their joints, and um it's so nice that we can focus on all of these things. So a woman shouldn't feel like if she can't take menopausal hormones, that she's left out in the cold. Um, and practicing now in 2026 compared to practicing in 1996, it's a world of difference in terms of so many options that we have. Now, just because we have these options doesn't mean we go to expensive newer medications, and of course, one of the issues that we deal with clinically is when new medications hit the market, a lot of times they're not on people's formulary. Our nurses need to do prior authorization paperwork, we physicians have to do more paperwork, sometimes women have to try a couple of options, even non-FDA-approved options to quote, fail before they can get the newer medicine. And it is uh pretty much a big challenge. One of the podcasts I think we did back in maybe June of 2023 was how to save money on medicines. And we update that column with the links, you know, to Good RX, Canadian Drugs, um, not all these medicines, but some of these medicines you can get the brand name for cash price, sometimes less than through someone's insurance. And there's Mark Cuban's website. Um, we're expecting sometime in 2026 the TrumRX.gov site, which is the government helping to direct uh patients, consumers to directly being able to buy medications from the drug manufacturer. Now I know that that's already in place for certain weight loss medicines, which are peptides. I mean these GLP, GIP, agonist like terzepatide, um, Manjaro is for the diabetics. That's the same thing as Zep Bound, which is the prescription drug for weight loss, which we don't prescribe directly in our specialized practice because there's just not enough people taking care of women with hot flashes and osteoporosis and sexual dysfunction, but we certainly have a lot of colleagues who do that, and it's very interesting because it's a peptide, and these neuro uh uh uh neurokinins and candy neuron inhibitors share certain similarities in terms of how they affect the brain, because the brain, which um affects our temperature regulation, our satiety, sleep, sexual function, a lot of things. This whole area of peptides is really exploding and um it's gonna be really fascinating to watch, and it will be fun to you know have you come back in another year or so and talk about other peptides and other options for super individualizing menopause therapy. Uh, but before we wrap up, I just want you to talk a little bit about your research that you presented at the menopause society this fall with Dr. Kahn, the research that you did on Omega 3s. You have a great column on speaking of women's health.com. And I encourage all of our listeners, if you don't have that bookmarked on your computer or phone, bookmark our website and use the general search button to search for any topic. And if you put omega, it'll pull up a lot, including podcasts, uh, but it will also pull up Dr. Sung's um article. So tell us about what you're researching.

Access, Cost, And Formularies

SPEAKER_01 27:38

So our research project wanted to see there's some correlation between uh among the symptoms and some anti-inflamm pro-inflammatory markers and omega ferric acid. So we are managing kind of menopause symptoms, but also sometimes it's not only because of the estrogen. Other conditions can be going on because of that we want to optimize all our patients' general conditions because of that, based on our patient symptoms, we sometimes rechecked the zinc, ferrogen level, TSH, and vitamin B12, and omega ferrous acid as well. So the this research board wanted to any correlation among the symptoms and dose marker, inflammatory marker and omega ferric acid. So the we just uh presented pilot data so far because we weren't able to collect much yet. But uh so still, even we didn't see much kind of great data yet, but definitely we were able to see some correlation among the inflammatory markers and some blood test results. For example, the omega-6 was correlated to ferritin level CRP. There is some correlation, and also unfortunately we didn't see much kind of correlation among symptoms and the marker, but definitely we were able to see that especially brain fog, even yes, take a look at the half flesh is nice, red, joint pain, a lot of different symptoms. But so far, my uh analysis showed brain fog was related to some ferritin level, jink level, and chase age level. I hope uh after I collect more data I can see more significant connection, the correlation among the markers and between the symptom and markers.

Peptides, Brain Pathways, Future Care

Dr. \ 29:18

Yeah, that is so fascinating, and uh I have been incorporating getting the omega ratios, which looks at the percent of omega-3 and omega-6. Those are two uh classes of uh fats that our body can't make that we need to ingest. And unfortunately, most Americans have way too much omega-6s, too much of the diet is way too much vegetable seed oils, which are inflammatory, and um I think that that does lead to more brain fog, a higher risk of um brain issues, cardiovascular issues, joint issues, dry eye, a lot of different problems that midlife women suffer. And I had mentioned that in 2026 it's um more exciting, and there's so many more options, and it's more optimistic to be able to treat women that are midlife and beyond, um, who need the whole symptom complex of hot flashes and bone health and genitourinary health taken care of. But even though we have more options, what I would say it's a lot harder work now when I'm seeing new menopausal patients than it was 20 or 30 years ago. And that's because so many of the women that we're seeing have metabolic syndrome. They have weight gain in the belly, they have high triglycerides and high lipids, um, they have diabetes or prediabetes, they have like what's called syndrome X. They have so much inflammation going on in their body, and they have a whole metabolic disorder on top of their hormonal disorder. And since there's so much in the media that now perimenopause and menopause people are talking about it and they know that it can be treated, and they're demanding to be evaluated and to be heard, that I think it's now more than ever important that we educate the physicians and nurse practitioners and people on the healthcare team because there's so many different people, whether they're pharmacists or our nurses, um, our medical assistants, um, physical therapist, occupational therapist, other subspecialties, um, you know, including hand surgery. I have a lot of hand surgeons send me women with uh terrible tendon inflammation because they're not potentially getting enough hormones, that we also educate women as well that not everything's going to be treated with estrogen, and that to be able to evaluate all those conditions and get someone on a better metabolic path, because most people in America die from cardiovascular causes. And some of my patients get a little irritated when I say, Oh, your blood pressure's up. Oh, no, it's not, it's always fine. No, no, we pulled it in, we have some elevated. No, it's always been fine. Yeah, everybody's blood pressure is always fine until it's not. Everybody might have used to been at a great weight when they were in high school, but now they're not, right? Um, everybody's blood sugar used to be maybe perfect, and they could eat sugar and not have elevated blood sugars, but when you get older that's just not the case, and sugar drives so many metabolic problems. Um and I tell patients it's because we're in the anti-aging field. We want you not to have half lashes so you can sleep well and your brain can function so you can go to work or take care of your family or do what you want to do with your life. We don't want you to outlive your skeleton because half of women do, and that's terrible. And with one in two women getting dementia, that's why we really care so much about brain health. So, any other final parting words, um, Dr. Sung? And how can people um who are in Northeast Ohio uh come and see you uh for general GYN? You you you know, we're recruiting you for our staff, and so are other people around the country, so we're so excited for you. Um so right now, anyway, how can someone uh get an appoint appointment with you?

SPEAKER_01 33:21

So coronavies uh just uh I see generic iron patient and was any kind of benign condition, I'm seeing those patients, and who's coming in during the annual checkup, complaining of perimenopause symptoms, post-menopausal, definitely I explain educate what it especially for perimenopause or women, I explain what's going on, what can happen, how we can manage it. I explained for those education more important in those populations, and who is really all that had a menopause suffering with menopause symptoms, definitely I explain all options, kind of hormonal, non-hormonal option I explain to everyone. And also I still see the younger population who needs contraception, still perimenopology women also definitely need contraception counseling. So I provide contraception counseling as well. I see uh also I do some guiding guidance procedure. So who needs some IUD, next flanon, or who needs endometrial biopsy for uh bleeding, abnormal bleeding, postmenopausal bleeding, I do the C dose procedure as well. So I I can see more focus on menopause management and bone health condition. And also I still uh I only did do some providings of sexual health conditions, so who has some issues definitely I can give some information and can guide what kind of help they can get. So that is usually what I do at my clinic at this moment. I just forgot to mention last thing. I would like to mention about the last part about uh the medication link because we just talked about perimenopause. So this medication, even the perimenopause woman has vesemoral symptoms, sure, there is no study for that because of that. We expect that definitely can help, but there is no clear data about that because of that, still this link and the physiolidatin and elites, both of them is only apply for postmenopause patients at this moment.

Dr. \ 35:09

Just for postmenopausal women and the number that people can call, I think it's 216-444-6601 to uh get an appointment with Dr. Naeang Sung. And thank you so much for joining us on Speaking of Women's Health. If you enjoyed this podcast, please give us a five star rating. Uh, you can share it with others. And if you don't get uh notifications on our podcast, uh make sure you enable your notifications and hit subscribe or collect. Remember, be strong, be healthy, and be in charge.