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
Diagnosis
Diagnosis and Symptoms of M...
...ociety (ES) suggests diagnosing meno...
...hing a diagnosis of menopause is ne...
...Considerations for All Menopausal Wo...
...esent during the menopausal transitio...
Table 1. Definitions of Spectrum o...
...ons That May Cause or Mimic Vasomotor...
...Genitourinary Syndrome of MenopauseHaving tro...
Treatment
...reatmen...
...4. Evaluating Cardiovascular Disease (CVD) R...
...Cancer Risk Cutoffs for Counseling Before R...
...y for Menopausal Symptom Relief...
...strogen and Progestogen Therap...
...r menopausal women
Cardiovascular R...
For wom...
...en at high risk of CVD, ES suggests...
For women with moderate risk of CVD, ES...
...nous Thromboembolic...
...or women at increased risk of venous thromboemboli...
...women with a uterus, ES recommends a progestoge...
...ast Cancer...
...nsidering MHT for menopausal sympto...
...at high or intermediate risk of breast cancer...
...ailoring MHT...
...ts a shared decision-making approach to dec...
...m-Compounded Hormones...
...ecommends using MHT preparations app...
...ine Estrogens with Bazedoxifene...
For symptomatic postmenopausal women with a u...
...bolone...
...en with bothersome VMS and climact...
...mmends against adding tibolone to other forms...
...ends against using tibolone in women w...
Clinical Management of Patients Taking Hormone Therapies
...agement of Patients Taking Hormone Therapies...
...itoring During Therapy
...men with persistent unscheduled bl...
...nforming women about the possible increas...
...at the decision to continue MHT be revisi...
...women with primary ovarian insuffi...
...ing Considerations...
...en preparing to discontinue MHT, ES s...
...able 6. Clinical Caveats During Treatment...
...nhormonal Therapies for VM...
...enopausal women with mild or less bothersome hot...
...nal Prescription Therapies for VMS...
...n seeking pharmacological management for moder...
...ose women seeking relief of moderate to s...
...ounter and Alternative Nonhormonal Therapies for...
...or women seeking relief of VMS wit...
...le 7. Alternative Therapies for Tr...
Treatment of Genitourinary Syndrome of Menopause
...Genitourinary Syndrome of Menopause...
...al Moisturizers and Lubr...
...tmenopausal women with symptoms of vu...
...o not produce sufficient vaginal secret...
...Estrogen Therapies...
...hout a history of hormone- (estrogen) depen...
...ho present with symptomatic GSM (including VVA)...
...omen taking raloxifene, without a hi...
...using low-dose vaginal ET, ES suggest...
...r women using vaginal ET who report p...
.... Classification of Government-Appro...
...pemifene...
...eatment of moderate to severe dyspareuni...
...with a history of breast cancer presentin...
...roach to the Patient with VMS Contemplating MH...
...c Cautions to Use of Systemic MHT or Sel...
...Commonly Prescribed Hormone TherapiesHaving t...