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
...gnosis...
...sis and Symptoms of Menopause...
...Society (ES) suggests diagnosing menopause...
...a diagnosis of menopause is necessary...
...iderations for All Menopausal Women...
...present during the menopausal transiti...
.... Definitions of Spectrum of Menopause H...
...e 2. Conditions That May Cause or Mi...
...ourinary Syndrome of MenopauseHaving trouble...
Treatment
...eatmen...
...ing Cardiovascular Disease (CVD) Risk in Women Co...
...able 5. Breast Cancer Risk Cutoffs fo...
...rmone Therapy for Menopausal Sympt...
...nd Progestogen Therapy...
...nopausal women...
...ovascular Risk...
...r women...
...at high risk of CVD, ES suggests initiating non...
...men with moderate risk of CVD, ES suggests t...
...us Thromboembolic Events...
...increased risk of venous thromboembol...
...with a uterus, ES recommends a progestogen...
...east Cancer...
...sidering MHT for menopausal symptom relief, ES...
...or women at high or intermediate risk o...
...oring MHT...
...ts a shared decision-making approach to d...
...ompounded Hormones...
...ing MHT preparations approved by the U...
...ine Estrogens with Bazedoxifene...
...postmenopausal women with a uterus and...
...bolone...
...en with bothersome VMS and climacteric symptoms an...
...recommends against adding tibolone to other form...
...mends against using tibolone in women with a...
Clinical Management of Patients Taking Hormone Therapies
Clinical Management of Patients Takin...
...nitoring During Therapy...
...omen with persistent unscheduled b...
...s informing women about the possible...
...s that the decision to continue MHT be revisited...
...women with primary ovarian insufficiency (POI),...
Stopping Consider...
...aring to discontinue MHT, ES suggests a shared...
...ble 6. Clinical Caveats During Trea...
...monal Therapies for VMS...
...usal women with mild or less bothersome hot flashe...
...rmonal Prescription Therapie...
...women seeking pharmacological management for...
...or those women seeking relief of m...
...e-Counter and Alternative Nonhormona...
...omen seeking relief of VMS with over-the-counter...
...7. Alternative Therapies for Treatment of...
Treatment of Genitourinary Syndrome of Menopause
...of Genitourinary Syndrome of Menopause...
...isturizers and Lubricants...
...usal women with symptoms of vulvovaginal atroph...
...omen who do not produce sufficient vaginal secre...
...l Estrogen Therapies...
...en without a history of hormone- (estrogen) de...
...men who present with symptomatic GSM (...
...omen taking raloxifene, without a history of hor...
...using low-dose vaginal ET, ES suggests aga...
...ing vaginal ET who report postmenopausal blee...
...fication of Government-Approved Vaginal Estro...
...emifene...
...tment of moderate to severe dyspareu...
...or women with a history of breast cance...
...Approach to the Patient with VMS Contemplati...
...pecific Cautions to Use of Systemic MHT or Selec...
...ly Prescribed Hormone TherapiesHaving t...