Menopause
Key Points
Key Points
Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or less than 10 years since the onset of menopause.
Health care professionals should individualize therapy based on clinical factors and patient preference.
Before initiating MHT, clinicians should screen women 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.
Diagnosis
...agnosis
...iagnosis and Symptoms of...
...Society (ES) suggests diagnosing menopau...
...establishing a diagnosis of menopause i...
...th Considerations for All Menopau...
...men present during the menopausal tr...
Table 1. Definitions of Spectrum of Menopau...
...Conditions That May Cause or Mimic Vasom...
...itourinary Syndrome of MenopauseHaving trouble...
Treatment
Treatment
...ing Cardiovascular Disease (CVD) Risk in Wome...
...able 5. Breast Cancer Risk Cutoffs for...
...rapy for Menopausal Symptom Relief...
...en and Progestogen Therapy...
...menopausal women...
...vascular Risk
...women...
...r women at high risk of CVD, ES suggests initia...
...n with moderate risk of CVD, ES suggests transd...
...hromboembolic Events...
...women at increased risk of venous thromboem...
...a uterus, ES recommends a progestogen (for examp...
...ast Cancer...
...considering MHT for menopausal symptom relief,...
...men at high or intermediate risk o...
...oring MHT...
...ared decision-making approach to deci...
...-Compounded Hormones...
...ds using MHT preparations approved by the...
...ted Equine Estrogens with Bazedoxif...
...matic postmenopausal women with a uterus and with...
...ibolone...
...or women with bothersome VMS and clim...
...ends against adding tibolone to other form...
ES recommends against using tibolo...
Clinical Management of Patients Taking Hormone Therapies
...ical Management of Patients Taking Hormon...
...ring During Therap...
...women with persistent unscheduled...
...s informing women about the possible increased r...
...s that the decision to continue MHT...
...g women with primary ovarian insufficie...
...ng Considerations...
...aring to discontinue MHT, ES suggests a shared de...
...inical Caveats During Treatment With MHT...
...hormonal Therapies for V...
...ausal women with mild or less both...
...ormonal Prescription Therapies for VMS...
...or women seeking pharmacological management...
...e women seeking relief of moderate to severe V...
...ter and Alternative Nonhormonal Therapies fo...
...r women seeking relief of VMS with ove...
.... Alternative Therapies for Treatment of VMSHav...
Treatment of Genitourinary Syndrome of Menopause
...tment of Genitourinary Syndrome of Menopa...
...l Moisturizers and Lubricants...
For postmenopausal women with symptoms of vulvova...
...do not produce sufficient vaginal secretions...
...inal Estrogen Therapie...
...omen without a history of hormone-...
...resent with symptomatic GSM (includ...
...ing raloxifene, without a history of hormone...
...or women using low-dose vaginal ET, ES suggests ag...
...women using vaginal ET who report postmenopausal b...
...ssification of Government-Approved Vaginal...
...emifene
...eatment of moderate to severe dyspareunia asso...
...women with a history of breast cancer presentin...
...1. Approach to the Patient with VMS...
...e 9. Specific Cautions to Use of Systemic MHT or...
...only Prescribed Hormone TherapiesHaving trouble...