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
Diagnosi...
...is and Symptoms of Menopau...
...Society (ES) suggests diagnosing menop...
...ng a diagnosis of menopause is necessary for...
...lth Considerations for All Menopausal Women
...women present during the menopausal tran...
...itions of Spectrum of Menopause Having trouble vi...
...tions That May Cause or Mimic Vasomotor Events an...
Table 3. Genitourinary Syndrome of MenopauseH...
Treatment
Treatm...
...uating Cardiovascular Disease (CVD) Risk in Wo...
...e 5. Breast Cancer Risk Cutoffs for Counseling...
...erapy for Menopausal Symptom Relief...
...en and Progestogen Ther...
...or menopausal wome...
...vascular Risk...
...or wome...
...en at high risk of CVD, ES suggests initiatin...
...h moderate risk of CVD, ES suggests tran...
...enous Thromboembolic Event...
...n at increased risk of venous thromb...
...ith a uterus, ES recommends a progestogen (fo...
Breast Ca...
...omen considering MHT for menopausal sympto...
...gh or intermediate risk of breast can...
...ailoring M...
...suggests a shared decision-making ap...
...tom-Compounded Hormone...
...ends using MHT preparations approved by the...
...gated Equine Estrogens with Bazedoxifene...
...tic postmenopausal women with a ute...
...bolone...
...n with bothersome VMS and climacteric symptoms and...
...mmends against adding tibolone to other forms of...
...nds against using tibolone in women with a his...
Clinical Management of Patients Taking Hormone Therapies
...l Management of Patients Taking Hormone Therapies...
...nitoring During Ther...
...women with persistent unscheduled...
...mmends informing women about the possible incr...
ES suggests that the decision to continue MHT...
...n with primary ovarian insufficiency...
...ng Considerations...
...aring to discontinue MHT, ES suggests a share...
...Clinical Caveats During Treatment With MHT H...
...rmonal Therapies for VMS...
...opausal women with mild or less bothe...
...onhormonal Prescription Therapies...
...en seeking pharmacological management for moderate...
...ose women seeking relief of moderate to s...
...-the-Counter and Alternative Nonhormonal Therapi...
...omen seeking relief of VMS with over-the-counter (...
...e 7. Alternative Therapies for Treatm...
Treatment of Genitourinary Syndrome of Menopause
...nitourinary Syndrome of Menopause...
Vaginal Moisturizers and Lubri...
...postmenopausal women with symptoms o...
...men who do not produce sufficient vaginal sec...
...Estrogen Therapies...
...ut a history of hormone- (estrogen)...
...present with symptomatic GSM (including VVA) with...
...raloxifene, without a history of hormone-...
...using low-dose vaginal ET, ES suggests against...
...g vaginal ET who report postmenopausal bleed...
...ssification of Government-Approved...
...spemifene
...tment of moderate to severe dyspareunia...
...n with a history of breast cancer pre...
...re 1. Approach to the Patient with VMS...
...ific Cautions to Use of Systemic MHT or Sele...
...10. Commonly Prescribed Hormone Thera...