“Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are…”.1

Umbrella
What may the Hormone Therapy 2012 Update Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Hormone Replacement Therapy (HRT)
  • Hormone Therapy (HT)
  • Menopausal Hormone Therapy (MHT)

Date

What can it be important to be clear about with hormone therapy (HT) information?

I think it can be important to be clear about the date of all information including the date of HT information, because this information may have been updated.

Symptoms or Chronic Conditions

What can it also be important to be clear about with HT information?

I think it can also be important to be clear about whether HT information is about the use of HT for the management of menopausal symptoms such as hot flushes, night sweats and vaginal dryness; or for the prevention of chronic conditions such as cardiovascular disease, cancer and osteoporosis.

2002 – 2012

In 2012, 10 years on from the (United States) Women’s Health Initiative (WHI) study published in 2002, how has the evidence changed about HT?

In The Women’s Health Initiative Study and Hormone Therapy – What Have We Learned 10 Years On? dated 22 May 2012, the International Menopause Society (IMS) explain:

“Now a major reappraisal by international experts, published as a series of articles in the peer-reviewed journal Climacteric (the official journal of the International Menopause Society), shows how the evidence has changed over the last 10 years, and supports a return to a “rational use of HT, initiated near the menopause””.2

In the joint statement 15 Top Medical Organizations Agree on Hormone Therapy: 10 Years Have Passed Since Women’s Health Initiative Raised Questions dated 09 July 2012, one of the major points of agreement is:

  • “Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms. Individualization is key in the decision to use hormone therapy”.3

Women’s Health Initiative

What was the Women’s Health Initiative (WHI)?

In Women’s Health Initiative (WHI): What Is the Goal of the WHI? the (United States) National Heart, Lung, and Blood Institute elaborate on:

“The Women’s Health Initiative (WHI), sponsored by the National Heart, Lung, and Blood Institute (NHLBI), is a long-term national health study that focuses on strategies for preventing heart disease, breast and colorectal cancer, and osteoporosis in postmenopausal women. These chronic diseases are the major causes of death, disability, and frailty in older women of all races and socioeconomic backgrounds”.4

Impact

What impact did the WHI study have on women choosing to use HT?

According to the IMS:

“In July 2002 the publication of the first Women’s Health Initiative (WHI) report caused a dramatic drop in Menopausal Hormone Therapy (HT) use throughout the world”.5

The (Australian) Jean Hailes for Women’s Health also note:

“In 2002, researchers from a large study in the United States (the Women’s Health Initiative trial, or WHI) reported that the risks of MHT outweighed the benefits of taking it. This caused an 80% drop in the use of MHT in the United States, and 50% of women in Australia stopped using their MHT”.6

2016

In 2016, what were some points of consensus about menopausal hormone therapy (MHT)?

Some points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT – endorsed by seven menopause-related organizations – published online 20 June 2016, were:

  • “MHT, including tibolone and the combination of conjugated equine estrogens and bazedoxifene (CE/BZA), is the most effective treatment for vasomotor symptoms (VMS) associated with menopause at any age, but benefits are more likely to outweigh risks if initiated for symptomatic women before the age of 60 years or within 10 years after menopause
  • If MHT is contraindicated or not desired for treatment of VMS, selective serotonin reuptake inhibitors and serotoninnorepinephrine reuptake inhibitors such as paroxetine, escitalopram, venlafaxine and desvenlafaxine, which have been shown to be effective in randomized controlled trials (RCTs), may be considered. Gabapentin may also be considered
  • Local low-dose estrogen therapy is preferred for women whose symptoms are limited to vaginal dryness or associated discomfort with intercourse or for the prevention of recurrent urinary tract infections”.7

Health Care Provider

What if I choose to use HT?

If you choose to use HT, it may be in your best interest to also choose to talk to your health care provider about this.

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT is:

  • “The option of MHT is an individual decision in terms of quality of life and health priorities as well as personal risk factors such as age, time since menopause and the risk of VTE, stroke, ischemic heart disease and breast cancer. MHT should not be recommended without a clear indication for its use”.8

What is VTE?

VTE can be an abbreviation for Venous Thromboembolism.

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Sources

Where may I find the Sources quoted?

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Sources

  1. 15 Top Medical Organizations Agree on Hormone Therapy Use: 10 Years Have Passed Since Women’s Health Initiative Raised Questions. 09 July 2012:2. North American Menopause Society, the American Society for Reproductive Medicine and the Endocrine Society https://www.menopause.org/docs/default-document-library/pr12solidarity.pdf?sfvrsn=2 Accessed: 29 June 2020
  2. The Women’s Health Initiative Study and Hormone Therapy – What Have We Learned 10 Years On? 22 May 2012:1. International Menopause Society https://www.imsociety.org/manage/images/pdf/d57d2677e5b33514624c4709ae8246c8.pdf Accessed: 29 June 2020
  3. 15 Top Medical Organizations Agree on Hormone Therapy Use: 10 Years Have Passed Since Women’s Health Initiative Raised Questions. 09 July 2012:2. North American Menopause Society, the American Society for Reproductive Medicine and the Endocrine Society https://www.menopause.org/docs/default-document-library/pr12solidarity.pdf?sfvrsn=2 Accessed: 29 June 2020
  4. Women’s Health Initiative (WHI): What Is the Goal of the WHI? National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov/science/womens-health-initiative-whi Accessed: 29 June 2020
  5. The Women’s Health Initiative Study and Hormone Therapy – What Have We Learned 10 Years On? 22 May 2012:1. International Menopause Society https://www.imsociety.org/manage/images/pdf/d57d2677e5b33514624c4709ae8246c8.pdf Accessed: 29 June 2020
  6. Menopause Management: Menopausal Hormone Therapy (MHT) – The Risks & Benefits of MHT? Last Updated: 07 April 2020 | Last Reviewed: 17 December 2017. Jean Hailes https://jeanhailes.org.au/health-a-z/menopause/menopause-management Accessed: 29 June 2020
  7. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 29 June 2020
  8. De Villiers, T. J., Hall, J. E., Pinkerton, J. V., Pérez, S. C., Rees, M., Yang, C. and Pierroz, D. D. Revised Global Consensus Statement on Menopausal Hormone Therapy: Section B: General Principles Governing the Use of MHT, Climacteric, 2016;19:4:314 https://www.imsociety.org/manage/images/pdf/ba6379e868044bec13015ac2b84f2753.pdf Accessed: 29 June 2020
Topic Last Updated: 29 June 2020 – Topic Last Reviewed: 29 June 2020
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