“Although not proven by studies, slowly decreasing your
dose of estrogen over several months or even over several
years may reduce the chance that your hot flashes…”.1

Umbrella
What may the Hormone Therapy and Stopping Umbrella include?

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

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

Right Time

Is there a right time to stop HT?

On page two in Deciding About Hormone Therapy Use: Stopping Hormone Therapy published July 2022, the North American Menopause Society (NAMS) note:

Hormone Therapy and Stopping

“There is no “right” time to stop HT. Many women try to stop HT after 4 to 5 years because of concerns about potential increased risk of breast cancer. Other women may lower doses or change to non-pill forms of HT. Hot flashes may or may not return after you stop HT”.2

Right Age

Is there a right age to stop HT?

On page two in the The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement published 07 July 2022, the NAMS explain:

Hormone Therapy and Stopping

  • “Hormone therapy does not need to be routinely discontinued in women aged older than 60 or 65 years and can be considered for continuation beyond age 65 for persistent VMS, quality-of-life issues, or prevention of osteoporosis after appropriate evaluation and counseling of benefits and risks
  • For women with GSM, vaginal estrogen (and systemic if required) or other nonestrogen therapies may be used at any age and for extended duration, if needed”.3

What is VMS?

VMS can be an abbreviation for Vasomotor Symptoms such as hot flushes or night sweats.

What is GSM?

GSM can be an abbreviation for Genitourinary Syndrome of Menopause.

On page two in the Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause first published online 10 June 2022, Hamoda et al. explain:

  • “The decision whether to take HRT, the dose and duration of its use should be made on an individualised basis after discussing the benefits and risks with each patient. This should be considered in the context of the overall benefits obtained from using HRT including symptom control and improving quality of life as well as considering the bone and cardiovascular benefits associated with HRT use. Discussions with women should also cover aspects such as when to consider stopping HRT and how this can be done (by gradually reducing the dose of HRT). No arbitrary limits should be set on age or duration of HRT intake”.4

Age 65

Is stopping HT routinely at the age of 65 recommended?

No. In Starting and Stopping Hormone Therapy: Risks and Benefits the European Menopause and Andropause Society (EMAS) explain:

“There are no arbitrary limits regarding how long MHT can be taken – it can be taken for as long as the woman feels the benefits outweigh the risks for her, and decisions must be made on an individual basis. Stopping routinely at the age of 65 is not recommended”.5

Right Way

Is there a right way to stop HT?

In Starting and Stopping Hormone Therapy: Stopping MHT the EMAS note:

  • “There appears to be no advantage in tapering down or in stopping abruptly”.6

The NAMS explain:

“Although not proven by studies, slowly decreasing your dose of estrogen over several months or even over several years may reduce the chance that your hot flashes will come back. You and your healthcare professional will work together to decide the best time to stop HT”.7

Health Care Provider

What if I unsure about when and how to stop HT?

If you are unsure about when and how to stop HT, it may be in your best interest to choose to talk to your health care provider about this. The NAMS explain:

“If very bothersome hot flashes or night sweats return when you stop HT, you will need to reassess your individual risks and benefits to decide whether to continue HT. Because there may be greater risks with longer duration of use and as you age, you and your healthcare professional will work together to decide what is the best option for you”.8

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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Deciding About Hormone Therapy Use: Stopping Hormone Therapy. 2022:2. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 15 November 2022
  2. Deciding About Hormone Therapy Use: Stopping Hormone Therapy. 2022:2. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 15 November 2022
  3. The North American Menopause Society Releases Its 2022 Hormone Therapy Position Statement. 07 July 2022:2. North American Menopause Society https://www.menopause.org/docs/default-source/press-release/ht-position-statement-release.pdf Accessed: 15 November 2022
  4. Hamoda, H., Mukherjee, A., Morris, E., Baldeweg, S. E., Jayesena, C. N., Briggs, P., Moger, S. Joint Position Statement By the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on Best Practice Recommendations for the Care of Women Experiencing the Menopause. First Published Online 10 June 2022 https://journals.sagepub.com/doi/full/10.1177/20533691221104879 Accessed: 15 November 2022
  5. Starting and Stopping Hormone Therapy: Stopping MHT. 2022. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/05/Starting-and-stopping-hormone-therapy.pdf Accessed: 15 November 2022
  6. Starting and Stopping Hormone Therapy: Risks and Benefits. 2022. European Menopause and Andropause Society https://emas-online.org/wp-content/uploads/2022/05/Starting-and-stopping-hormone-therapy.pdf Accessed: 15 November 2022
  7. Deciding About Hormone Therapy Use: Stopping Hormone Therapy. 2022:2. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 15 November 2022
  8. Deciding About Hormone Therapy Use: Stopping Hormone Therapy. 2022:2. North American Menopause Society https://www.menopause.org/docs/default-source/professional/menonote-deciding-about-ht-2022.pdf Accessed: 15 November 2022
Topic Last Updated: 15 November 2022  – Topic Last Reviewed: 15 November 2022

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