Treatment of symptoms of the menopause. Еndocrine society clinical practice guideline

Authors

  • Cynthia A. Stuenkel University of California, San Diego, California, United States
  • Susan R. Davis Monash University, School of Public Health and Preventive Medicine, Melbourne, Australia
  • Anne Gompel Universite´ Paris Descartes, Paris, France
  • Mary Ann Lumsden University of Glasgow School of Medicine, Glasgow, United Kingdom
  • M. Hassan Murad Mayo Clinic, Division of Preventive Medicine, Rochester, Minnesota, United States
  • JoAnn V. Pinkerton Menopause Clinic, University of Virginia, Obstetrics and Gynecology, Charlottesville, Virginia, United States
  • Richard J. Santen University of Virginia Health System, Charlottesville, Virginia, United States

DOI:

https://doi.org/10.18370/2309-4117.2015.26.86-93

Keywords:

menopause, clinical guideline, US Endocrine Society

Abstract

The objective of this document is to generate a practice guideline for the management and treatment of symptoms of the menopause.

The Treatment of Symptoms of the Menopause Task Force included six experts, a methodologist, and a medical writer, all appointed by The Endocrine Society.

The Task Force developed this evidenced-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews of published data and considered several other existing meta-analyses and trials.

Multiple e-mail communications, conference calls, and one face-to-face meeting determined consensus. Committees of The Endocrine Society, representatives from endorsing societies, and members of The Endocrine Society reviewed and commented on the drafts of the guidelines. The Australasian Menopause Society, the British Menopause Society, European Menopause and Andropause Society, the European Society of Endocrinology, and the International Menopause Society (co-sponsors of the guideline) reviewed and commented on the draft.

Conclusions: 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 under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT 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.

Author Biographies

Cynthia A. Stuenkel, University of California, San Diego, California

MD, рrofessor

Susan R. Davis, Monash University, School of Public Health and Preventive Medicine, Melbourne

MD, рrofessor

Anne Gompel, Universite´ Paris Descartes, Paris

MD, рrofessor

Mary Ann Lumsden, University of Glasgow School of Medicine, Glasgow

MD, рrofessor

M. Hassan Murad, Mayo Clinic, Division of Preventive Medicine, Rochester, Minnesota

MD, рrofessor 

JoAnn V. Pinkerton, Menopause Clinic, University of Virginia, Obstetrics and Gynecology, Charlottesville, Virginia

MD, рrofessor, Medical Director 

Richard J. Santen, University of Virginia Health System, Charlottesville, Virginia

MD, рrofessor

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Published

2015-12-28

How to Cite

Stuenkel, C. A., Davis, S. R., Gompel, A., Lumsden, M. A., Murad, M. H., Pinkerton, J. V., & Santen, R. J. (2015). Treatment of symptoms of the menopause. Еndocrine society clinical practice guideline. REPRODUCTIVE ENDOCRINOLOGY, (26), 86–93. https://doi.org/10.18370/2309-4117.2015.26.86-93

Issue

No. 26 (2015)

Section

Management of menopause

License

Copyright (c) 2015 Cynthia A. Stuenkel, Susan R. Davis, Anne Gompel, Mary Ann Lumsden, M. Hassan Murad, JoAnn V. Pinkerton, Richard J. Santen

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