Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline.
By C. Stuenkel, S. Davis, A. Gompel, M. Lumsden, M. H. Murad, Jo Ann V. Pinkerton, R. J. Santen. Journal of Clinical Endocrinology and Metabolism, 2015
765 citations recorded by the source corpus.
OBJECTIVE The objective of this document is to generate a practice guideline for the management and treatment of symptoms of the menopause. PARTICIPANTS The Treatment of Symptoms of the Menopause Task Force included six experts, a methodologist, and a medical writer, all appointed by The Endocrine Society. EVIDENCE The Task Force developed this evidenced-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews of published data and considered several other existing meta-analyses and trials. CONSENSUS PROCESS Multiple e-mail communications, conference calls, and one face-to-face meeting determined consensus. Committees of The Endocrine Society, representatives from endorsing societies, and members of The Endocrine Society reviewed and commented on the drafts of the guidelines. The Australasian Menopause Society, the British Menopause Society, European Menopause and Andropause Society, the European Society of Endocrinology, and the International Menopause Society (co-sponsors of the guideline) reviewed and commented on the draft. CONCLUSIONS Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric. Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT for cardiovascular and breast cancer risk and recommend the most appropriate therapy depending on risk/benefit considerations. Current evidence does not justify the use of MHT to prevent coronary heart disease, breast cancer, or dementia. Other options are available for those with vasomotor symptoms who prefer not to use MHT or who have contraindications because these patients should not use MHT. Low-dose vaginal estrogen and ospemifene provide effective therapy for the genitourinary syndrome of menopause, and vaginal moisturizers and lubricants are available for those not choosing hormonal therapy. All postmenopausal women should embrace appropriate lifestyle measures.
Subfields: Endocrinology, Diabetes and Metabolism, Genetics, Pulmonary and Respiratory Medicine
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Citations in the corpus
- Cardiovascular disease in women (2010, neutral): “The microvasculature in women may play an important role in the predisposition of women with autoimmune diseases to develop accelerated CVD.80 The female to male ratio for rheumatoid arthritis is 2.5:1 and for systemic lupus erythematosus is 9:1.”
- The 2022 hormone therapy position statement of The North American Menopause Society (2022, neutral): “The reason that hormone therapy was not shown to reduce hip fracture in the subset of women aged 50 to 59 years in the WHI may be partly because of the lower baseline absolute risk of fracture in women aged between 50 and 59 years who did not have established osteoporosis.(9,168)”
- Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society* Clinical Practice Guideline. (2019, background): “The benefits and risks of estrogen and tibolone need to be evaluated on an individual basis (102).”