Menopause

Publication Date: November 1, 2015

Key Points

Key Points

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 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

Diagnosis

...gnosis and Symptoms of Menopause...

...ociety (ES) suggests diagnosing menopause b...

...tablishing a diagnosis of menopause...


...Considerations for All Menopausal Women...

...men present during the menopausal transition, ES...

...efinitions of Spectrum of Menopause Having troub...

...ons That May Cause or Mimic Vasomotor Events a...

...rinary Syndrome of MenopauseHaving...


Treatment

...eatment...

...e 4. Evaluating Cardiovascular Disease...


...ble 5. Breast Cancer Risk Cutoffs for Counselin...


...apy for Menopausal Symptom Relief...

...nd Progestogen Therapy...

...or menopausal...

...ardiovascular Ris...

...women...

...high risk of CVD, ES suggests initiating n...

...women with moderate risk of CVD, ES suggests...

...hromboembolic Events...

...women at increased risk of venous thrombo...

...a uterus, ES recommends a progestoge...

...st Cancer...

...omen considering MHT for menopausal symp...

...high or intermediate risk of breast cancer cons...


...loring MHT...

...uggests a shared decision-making approach to dec...


...-Compounded Hormones...

...ds using MHT preparations approved by th...


...quine Estrogens with Bazedoxifene...

...symptomatic postmenopausal women with a uterus...


...ibolone...

...bothersome VMS and climacteric symptoms an...

...ainst adding tibolone to other forms of MHT. (1-L)...

...against using tibolone in women with a hist...


Clinical Management of Patients Taking Hormone Therapies

Clinical Management of Patients Taking Hormone...

...itoring During Therapy

...persistent unscheduled bleeding while taking...

...recommends informing women about the pos...

...suggests that the decision to continu...

...omen with primary ovarian insufficiency (POI...


...g Considerations...

...eparing to discontinue MHT, ES suggests a share...


...le 6. Clinical Caveats During Treatmen...


...monal Therapies for VMS...

...postmenopausal women with mild or less bothersom...


...al Prescription Therapies for VMS...

...eking pharmacological management for...

...en seeking relief of moderate to s...


...-Counter and Alternative Nonhormonal Ther...

...omen seeking relief of VMS with over-the-co...


...rnative Therapies for Treatment of VMSHaving tro...


Treatment of Genitourinary Syndrome of Menopause

...Genitourinary Syndrome of Menopause...

Vaginal Moisturizers and Lubri...

...ausal women with symptoms of vulvova...

...women who do not produce sufficient...


...aginal Estrogen Therapie...

...ithout a history of hormone- (estrogen) depende...

...n who present with symptomatic GSM (including V...

...omen taking raloxifene, without a his...

...n using low-dose vaginal ET, ES suggest...

For women using vaginal ET who report postmenop...


...Classification of Government-Approve...


...pemifene

...r treatment of moderate to severe dyspareunia ass...

...men with a history of breast cancer presenting...


...ch to the Patient with VMS Contemplating MHT...


...Specific Cautions to Use of Systemic MHT or Sel...


...nly Prescribed Hormone TherapiesHaving...