Hormone Therapy Benefits and Risks

“The risks and benefits of MHT differ for
women during the menopause transition
compared to those for older women”.1

Umbrella
What may the Hormone Therapy Benefits and Risks Umbrella include?

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

  • HRT/HT/MHT Benefits and Risks
  • HRT/HT/MHT Health Benefits and Risks
  • HRT/HT/MHT Pros and Cons
  • HRT/HT/MHT Risks and Benefits
  • 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) benefits and risks information?

It can be important to be clear about the date of all information including the date of HT benefits and risks information, because this information may have been updated.

Symptoms or Chronic Conditions

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

It can also be important to be clear about whether HT benefits and risks 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.

Individualised Benefits and Risks

How important is it to understand what my benefits and risks are?

In Hormone Replacement Therapy (HRT): Benefits and Risks the (United Kingdom) NHS elaborate on:

“When deciding whether to have hormone replacement therapy (HRT), it’s important to understand the benefits and risks.

Many studies on HRT published over the past 15 years highlight the potential risks. As a result, some women and doctors have been reluctant to use HRT.

But recent evidence says that the risks of HRT are small and are usually outweighed by the benefits”.2

Benefits and Risk

What are some HT benefits and risks?

On page one in Deciding About Hormone Therapy Use: Potential Benefits published in June 2017, the North American Menopause Society (NAMS) explain:

“Hormone therapy is one of the most effective treatments available for bothersome hot flashes and night sweats. If night sweats are waking you throughout the night, HT may improve sleep and fatigue, mood, ability to concentrate, and overall quality of life. Treatment of bothersome hot flashes and night sweats is the principal reason women use HT. Hormone therapy also treats vaginal dryness and painful sex associated with menopause. Hormone therapy keeps your bones strong by preserving bone density and decreasing your risk of osteoporosis and fractures. If preserving bone density is your only concern, and you do not have bothersome hot flashes, other treatments may be recommended instead of HT”.3

Benefits and Risks Differences

Can HT benefits and risks be different for different women?

Yes. HT benefits and risks can be different for different women. These differences may include:

Hormone Therapy Benefits and Risks Differences

  1. Product Differences
  2. Symptom Differences
  3. Individual Differences
  4. Age Differences
  5. Time Since Menopause Differences
  6. Risk Factor Differences
  7. Health Conditions Differences
  8. Uterus Differences
  9. EPT and ET Differences
  10. Option Differences
  11. Duration Differences

1. Product Differences

Can menopausal hormone therapy (MHT) benefits and risks be different for different hormonal products?

One of the governing principles in the International Menopause Society’s (IMS) 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy: IMS Governing Principles on MHT published online 12 February 2016, is:

  • “MHT includes a wide range of hormonal products and routes of administration, with potentially different risks and benefits. Thus, the term ‘class effect’ is confusing and inappropriate. However, evidence regarding differences in risks and benefits between different products is limited”.4

2. Symptom Differences

Can MHT benefits and risks differ for women with different menopause symptoms?

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT is:

  • “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”.5

3. Individual Differences

Can MHT benefits and risks differ for individual women?

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”.6

What is VTE?

VTE can be an abbreviation for Venous Thromboemolism.

4. Age Differences

Can MHT benefits and risks differ for women of different ages?

One of the governing principles in the 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy: IMS Governing Principles on MHT is:

Hormone Therapy Benefits and Risks

  • “The risks and benefits of MHT differ for women during the menopause transition compared to those for older women”.7

One of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT is:

  • “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”.8

What are vasomotor symptoms?

DotS the definition of vasomotor symptoms may vary. The North American Menopause Society’s definition is:

“Vasomotor symptoms. Also known as hot flashes and night sweats, common symptoms during perimenopause and early postmenopause”.9

5. Time Since Menopause Differences

Can MHT benefits and risks differ for women with different times since menopause?

As noted above, one of the points of consensus in the Revised Global Consensus Statement on Menopausal Hormone Therapy: Section A: Benefit/Risk Profile of MHT is:

  • “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”.10

6. Risk Factor Differences

Can HT risks differ for women with different risk factors?

On page one in the NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use published on 20 June 2017, the NAMS elaborate on:

  • “The risks of HT differ for different women, depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is needed. Treatment should be individualized using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation for the benefits and risks of HT continuation”.11

In Menopause: Menopause – Hormone Treatments the (United States) U.S. Food and Drug Administration (FDA) also note:

“In some women, Menopause Hormone Therapy may increase risks of serious side effects including blood clots, heart attacks, strokes, breast cancer, and gall bladder disease”.12

7. Health Conditions Differences

Can HT risks differ for different women with different health conditions?

In Menopause: Menopause – Hormone Treatment? the FDA explain:

“You should not take hormone therapy for menopause if:

  • You think you are pregnant
  • You have problems with vaginal bleeding
  • You have had certain kinds of cancers
  • You have had a stroke or heart attack
  • You have had blood clots
  • You have liver disease”.13

8. Uterus Differences

Can HT benefits and risks differ for women who have a uterus?

Hormone Therapy Benefits and RisksIn Menopause FAQS: Hormone Therapy – Q. What Is Hormone Therapy? the NAMS note:

“A. …Women who still have a uterus need to take a progestogen in addition to estrogen or the estrogen-SERM combination to protect against uterine cancer”.14

Hormone Therapy Benefits and RisksIf you do not have a uterus, in Menopause FAQS: Hormone Therapy – Q. What Is Hormone Therapy? the NAMS also note:

“A. …Women who have had a hysterectomy (had their uterus removed) can use estrogen alone to control their hot flashes”.15

9. ET and EPT Differences

Can HT benefits and risks differ for women who use ET and women who use EPT?

The NAMS explain:

“…you and your healthcare provider need to balance the benefits and risks you have. For example, if you don’t have a uterus and can take estrogen therapy (ET) alone, your risks are different from those of women who still have a uterus and must use estrogen plus progestogen (EPT) to protect against uterine cancer”.16

10. Option Differences

Can HT benefits and risks differ for different HT options?

On page two in Deciding About Hormone Use: Pill or Non-Pill the NAMS explain:

“Hormone therapy is available as a daily pill, but it also may be taken as a skin patch, gel, cream, spray, or vaginal ring. Non-pill forms may be more convenient. Hormone therapy pills need to be taken every day, but skin patches are changed only once or twice weekly, and the HT vaginal ring is changed only every 3 months. Hormone therapy taken in non-pill form enters your blood stream more directly, with less effect on the liver. Studies suggest that this may lower the risk of blood clots in the legs and lungs compared with HT taken as a pill”.17

11. Duration Differences

Can HT benefits and risks differ for women who choose to use HT for different durations or lengths of time?

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:

  • “Duration of treatment should be consistent with the treatment goals of the individual, and the benefit/risk profile needs to be individually reassessed annually. This is important in view of new data indicating longer duration of VMS in some women”.18

The NAMS explain:

  • “How long you should take HT is different for EPT and ET”.19

In the NICE Guideline Menopause: Diagnosis and Management – Information for the Public: Treating Menopausal Symptoms the (British) National Institute for Health and Care Excellence’s (NICE) elaborate on:

“If HRT is suitable for you and you are interested in taking it, your GP should discuss the benefits and risks with you, both in the short term (the next 5 years) and in the future, before you decide to start it.

You should also be given information about:

  • Non-hormonal treatments, for example a drug called clonidine
  • Other types of treatments, such as cognitive behavioural therapy (CBT), a type of psychological therapy that helps people to manage the way they think and feel”.20

Who is a GP?

Dots and/or DotC (Depending on the Country) a GP may be a registered general practitioner, a medical practitioner, a medical doctor or a doctor.

Health Care Provider

If I choose to use HT, how can I find out what my benefits and risks are?

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.

In BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women the British Menopause Society and Women’s Health Concern note:

Hormone Therapy Benefits and Risks

“The decision whether to take HRT, the dose of HRT used and the 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”.21

One of the governing principles in the 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy: IMS Governing Principles on MHT is:

  • “Consideration of MHT should be part of an overall strategy including lifestyle recommendations regarding diet, exercise, smoking cessation and safe levels of alcohol consumption for maintaining the health of peri- and postmenopausal women”.22

On page one in Deciding About Hormone Use the NAMS explain:

“Every woman is different—and you must make a decision about whether to use HT based on the severity of your symptoms, your personal and family health history, and your own beliefs about menopause treatments. Your healthcare provider will be able to help you with your decision”.23

In Menopause Management: Menopause Hormone Therapy (MHT) – Should You Take MHT? the (Australian) Jean Hailes for Women’s Health (JH) elaborate on:

  • “Jean Hailes strongly advocates that women take a balanced, evidence-based and informed approach to their healthcare: all risks and benefits should be considered when deciding whether to use MHT
  • Current recommendations by world experts in menopause, including our own doctors, suggest the benefits of MHT outweigh the risks for healthy menopausal women”.24

The JH also note:

  • “Jean Hailes recommends each woman discusses her decision about taking MHT with her doctor regularly and whenever there are any concerns”.25

In Menopause: Diagnosis & Treatment: Treatment – Hormone Therapy the Mayo Clinic note:

“Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change”.26

Health Topics A-Z

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Health Topics A-Z

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  1. 20 Years of Data Lead To Changes In Perceptions, Usage of Menopausal HT
  2. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 6. Myth – Complementary Medicines and Therapies Are As Effective As MHT and Safer
  3. 9 Myths and Misunderstandings About Menopausal Hormone Therapy (MHT): 7. Myth – Compounded Bioidentical Hormone Therapy Is Safer Than Conventional MHT
  4. Askearlymenopause.org [Ask EM] [+ Video: What Is Early Menopause?]
  5. Association Between Menopausal Hormone Therapy and Risk of Neurodegenerative Diseases: Implications for Precision Hormone Therapy
  6. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women
  7. Bioidentical Hormones Explained – A British Menopause Society Video
  8. Bioidentical Hormones: Are They Safer?
  9. Combined Menopausal Hormone Therapy (MHT)
  10. Complementary Medicine Options for Menopausal Symptoms
  11. Complementary and Alternative Therapies Explained – A British Menopause Society Video
  12. Compounded Bioidentical Hormone Therapy [Video]
  13. Consumer Health: Menopause, Hormone Replacement Therapy and Heart Health
  14. Deciding About Hormone Therapy
  15. Deciding About Hormone Therapy Use
  16. EMAS Replay [Multiply Languages]
  17. EMAS Replay: Risk Assessment for MHT – When, To Whom, Which, and How Long? [Multiply Languages]
  18. EMAS Replay: The Relevance of Estrogen and Progestogen Choice for Breast Safety During MHT [Multiply Languages]
  19. Early Menopause: Experiences and Perspectives of Women and Health Practitioners – Women’s Profiles
  20. Estrogen & Hormones
  21. Estrogen & Hormones: Estrogen and the Cardiovascular System
  22. Estrogen & Hormones: Postmenopausal Hormone Replacement Therapy
  23. Family History
  24. Fast Facts: HRT and Breast Cancer Risk
  25. Find A Menopause Practitioner [United States and Other]
  26. Find An AMS Doctor [Australasian Menopause Society i.e. Australia and New Zealand]
  27. Find Your Nearest BMS Menopause Specialist [British Menopause Society]
  28. HRT
  29. HRT and Breast Cancer: Overall Risks and Benefits Explained – A British Menopause Society Video
  30. HRT and the Risk of Breast Cancer Explained – A British Menopause Society Video
  31. HRT: Benefits and Risks
  32. HRT: The History
  33. HRT: Types, Doses and Regimens
  34. Hormone Replacement Therapy
  35. Hormone Replacement Therapy (HRT)
  36. Hormone Replacement Therapy (HRT) Explained – A British Menopause Society Video
  37. Hormone Replacement Therapy (HRT): Benefits and Risks
  38. Hormone Replacement Therapy (HRT): Overview – Benefits of HRT
  39. Hormone Replacement Therapy (HRT): Overview – Who Can Take HRT
  40. Hormone Replacement Therapy (HRT): Types
  41. Hormone Replacement Therapy Safe, Despite Rare Blood Clot Risks From Tablets
  42. Hormone Therapy for Menopause
  43. Hormone Therapy: Is It Right for You?
  44. Index To Drug-Specific Information [United States]
  45. Information About Menopause [Multiply Languages] [Videos]
  46. MHT Still Maligned & Misunderstood: Expert
  47. MHT and Breast Cancer Risk
  48. Making Choices At Menopause
  49. Making Sense of Menopausal Hormone Therapy Means Understanding the Benefits As Well As the Risks
  50. Managing Menopausal Symptoms—Hormone Replacement Therapy Is Not the Only Option!
  51. Menopausal Hormone Therapy and Women’s Health: An Umbrella Review
  52. Menopause
  53. Menopause
  54. Menopause
  55. Menopause
  56. Menopause & Hormones: Questions To Ask Your Doctor
  57. Menopause FAQs: Hormone Therapy for Menopause Symptoms
  58. Menopause Hormone Therapy and Your Heart
  59. Menopause Hormone Therapy: Does It Cause Vaginal Bleeding?
  60. Menopause Hormone Therapy: Follow-Up Appointments?
  61. Menopause Hormone Therapy: Who Shouldn’t Take It?
  62. Menopause Management: Hormone Replacement Therapy (HRT) – Benefits & Risks of HRT
  63. Menopause Management: Hormone Replacement Therapy (HRT) – What Are the Risks of HRT?
  64. Menopause Map: Downloadable Resources – My Personal Path Print Tools: Questions for Your Health Care Provider
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  65. Menopause Matters
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  68. Menopause: Diagnosis & Treatment
  69. Menopause: Diagnosis and Management – Information for the Public: Benefits and Risks of HRT [NICE Guideline]
  70. Menopause: Diagnosis and Management – Information for the Public: Questions To Ask About Menopause [NICE Guideline]
  71. Menopause: Is Menopausal Hormone Therapy (HRT) Safe? [Multiply Languages] [Video]
  72. Menopause: Medicines To Help You
  73. Menopause: Menopause – Hormone Treatments
  74. Menopause: What Are the Benefits and Risks of Long-Term Hormone Therapy?
  75. Menopause: What Is Menopausal Hormone Therapy (HRT)? [Multiply Languages] [Video]
  76. Misinterpretation of WHI Results Decreased Use of Hormones, Even In Women Not At Risk [Women’s Health Initiative]
  77. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use
  78. NonHormonal Treatments for Menopausal Symptoms
  79. Oestrogen Only Menopausal Hormone Therapy
  80. Risks and Benefits of MHT
  81. Study IDs Non-Hormonal Options for Menopause Symptoms [+ Video]
  82. The Menopause: Hormone Replacement Therapy (HRT) [+ Video: Is HRT Bad for You?]
  83. The Menopause: Treating Menopause Symptoms [+ Video: Talking Menopause With Your GP]
  84. Types of Hormone Therapy
  85. Urogenital Atrophy Explained – A British Menopause Society Video
  86. Venous Thrombosis/Thromboembolism Risk and Menopausal Treatments
  87. Video Series-2021: Treatment Options for Vaginal Dryness and Urinary Issues
  88. Video Series-2021: What Women Need to Know About Hormone Therapies
  89. Video Series-2022: Hormone Therapy: Understanding the Risks and Benefits
  90. Video Series-2022: New Treatment Options for Menopause Symptoms Are Around the Corner
  91. Video Series-2022: Perimenopause, Signs, Symptoms, and Solutions
  92. Video Series-2022: Understanding Screening Guidelines for Breast Cancer and the Importance of Identifying Risk Factors
  93. Videos and Podcasts: Interviews and Podcasts – Interviews: Prevention of Chronic Diseases In Women: Where Does MHT Fit In?
  94. Videos and Podcasts: Interviews and Podcasts – Interviews: The Women’s Health Initiative – What Can We Believe?
  95. Vietnamese: What Is Menopausal Hormone Therapy (MHT) and Is It Safe?
  96. Webinars: Previous – 2021 Vision: Practical Steps To Optimize Your Benefit-Risk. Discussions for A New Decade
  97. Webinars: Previous – Breast Cancer
  98. Webinars: Previous – Progestogen, Progestin, Progesterone: Why All the Confusion?
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  100. What Is Menopausal Hormone Therapy (MHT) and Is It Safe?

Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. Baber, R. J., Panay N. and Fenton, A., the IMS Writing Group. 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy: IMS Governing Principles on MHT. Climacteric 19:2, 110 https://www.imsociety.org/wp-content/uploads/2020/08/2016-ims-hrt-health-recommendations-english.pdf Accessed: 31 March 2022
  2. Hormone Replacement Therapy (HRT): Benefits and Risks. Page Last Reviewed: 09 September 2019. NHS https://www.nhs.uk/conditions/hormone-replacement-therapy-hrt/risks/ Accessed: 31 March 2022
  3. Deciding About Hormone Therapy Use: Potential Benefits. 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 31 March 2022
  4. Baber, R. J., Panay N. and Fenton, A., the IMS Writing Group. 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy: IMS Governing Principles on MHT. Climacteric 19:2, 111 https://www.imsociety.org/wp-content/uploads/2020/08/2016-ims-hrt-health-recommendations-english.pdf Accessed: 31 March 2022
  5. 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/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 31 March 2022
  6. 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/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 31 March 2022
  7. Baber, R. J., Panay N. and Fenton, A., the IMS Writing Group. 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy: IMS Governing Principles on MHT. Climacteric 19:2, 110 https://www.imsociety.org/wp-content/uploads/2020/08/2016-ims-hrt-health-recommendations-english.pdf Accessed: 31 March 2022
  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 A: Benefit/Risk Profile of MHT. Climacteric, 2016;19:4:313 https://www.imsociety.org/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 31 March 2022
  9. Glossary: V – Vasomotor Symptoms. North American Menopause Society http://www.menopause.org/for-women/menopause-glossary#V Accessed: 31 March 2022
  10. De Villiers, T. J, Hall,  J. E., Pinkerton, JV, 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/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 31 March 2022
  11. NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use. 20 June 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/default-document-library/ht-press-release-061917.pdf Accessed: 31 March 2022
  12. Menopause: Menopause – Hormone Treatments. Content Current As of: 22 August 2019. Food and Drug Administration https://www.fda.gov/consumers/womens-health-topics/menopause Accessed: 31 March 2022
  13. Menopause: Menopause – Hormone Treatments. Content Current As of: 22 August 2019. Food and Drug Administration https://www.fda.gov/consumers/womens-health-topics/menopause Accessed: 31 March 2022
  14. Menopause FAQS: Hormone Therapy – Q. What Is Hormone Therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 31 March 2022
  15. Menopause FAQS: Hormone Therapy – Q. What Is Hormone Therapy? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-hormone-therapy-for-menopause-symptoms Accessed: 31 March 2022
  16. News You Can Use About Hormone Therapy: Benefits. North American Menopause Society https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/news-you-can-use-about-hormone-therapy Accessed: 31 March 2022
  17. Deciding About Hormone Therapy Use: Potential Benefits. 2017:2. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 31 March 2022
  18. 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/wp-content/uploads/2020/08/global-consensus-hrt-2016-06.pdf Accessed: 31 March 2022
  19. Hormone Therapy for Women In 2012. 2012:2. North American Menopause Society https://www.menopause.org/docs/default-document-library/psht12patient.pdf?sfvrsn=2 Accessed: 31 March 2022
  20. Menopause: Diagnosis and Management – Information for the Public: Treating Menopausal Symptoms. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Treating-menopausal-symptoms Accessed: 31 March 2022
  21. BMS & WHC’s 2020 Recommendations on Hormone Replacement Therapy In Menopausal Women. Updated March 2021. British Menopause Society and Women’s Health Concern https://thebms.org.uk/publications/consensus-statements/bms-whcs-2020-recommendations-on-hormone-replacement-therapy-in-menopausal-women/ Accessed: 31 March 2022
  22. Baber, R. J., Panay N. and Fenton, A., the IMS Writing Group. 2016 IMS Recommendations on Women’s Midlife Health and Menopause Hormone Therapy: IMS Governing Principles on MHT. Climacteric 19:2, 110 https://www.imsociety.org/wp-content/uploads/2020/08/2016-ims-hrt-health-recommendations-english.pdf Accessed: 31 March 2022
  23. Deciding About Hormone Therapy Use. 2017:1. North American Menopause Society https://www.menopause.org/docs/default-source/for-women/menonote-deciding-about-ht-2017.pdf Accessed: 31 March 2022
  24. Menopause Management: Menopausal Hormone Therapy (MHT) – Should You Take MHT? Last Updated: 13 July 2021 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 31 March 2022
  25. Menopause Management: Menopausal Hormone Therapy (MHT) – Should You Take MHT? Last Updated:  13 July 2021 | Last Reviewed: 17 December 2017. Jean Hailes for Women’s Health https://jeanhailes.org.au/health-a-z/menopause/menopause-management/ Accessed: 31 March 2022
  26. Menopause: Diagnosis & Treatment – Treatment: Hormone Therapy. 14 October 2020. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 31 March 2022

Topic Last Updated: 09 May 2022 – Topic Last Reviewed: 31 March 2022
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