What’s the latest recommendation on HRT?

0 Answers

  1. Staness Jonekos wrote on :

    This is a great question.

    The North American Menopause Society (NAMS) has updated its 2008 recommendations (JW Womens Health Aug 2008, p. 61, and Menopause 2008; 15:584) for use of postmenopausal hormone therapy (HT) based on new evidence and collaboration with other professional societies. The statement addresses only prescription HT products available in the U.S. and Canada.

    The most recent guidelines acknowledge accumulating evidence that various estrogen and progestogen products, routes of administration, and timing of therapy confer differing benefit-risk profiles.

    Additions to previous recommendations include the following:

    -HT is not recommended for women with histories of endometrial cancer.
    -In breast cancer survivors, estrogen therapy (ET) has not been proven safe and might raise recurrence risk.
    -Intrauterine systems cannot be recommended for endometrial protection in ET users.
    -When HT is discontinued after several years of use, bone-mineral density should be assessed, and medication to prevent fractures should be initiated, if appropriate.

    NAMS reiterates that, although HT is not recommended for heart disease protection, its initiation by younger women (age range, 50–59) or within 10 years after menopause does not seem to raise risk for coronary heart disease (CHD); emerging evidence suggests that ET initiation early in menopause might lower CHD risk. The guidelines state that “because incidence of disease outcomes increases with age and time since menopause, the benefit-risk ratio for HT is more likely to be acceptable for short-term use for symptom reduction in a younger population. In contrast, long-term HT or HT initiation in older women may have a less acceptable ratio.”

    We are all different. We each have a different personal and family medical history, as well as personal preferences, so building a strong relationship with your clinician is important when managing menopause symptoms. When considering HT the product, timing of therapy, dose, duration, route of administration and risk factors must be considered – it is highly individualized.

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