“…benefits are more likely to outweigh risks if initiated for symptomatic women before the age of 60 years or within 10 years after menopause”.1

Umbrella
What may the Hormone Therapy Postmenopause Umbrella include?

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

  • Hormone Replacement Therapy (HRT) After Menopause
  • Hormone Therapy (HT) After Menopause
  • Menopausal Hormone Therapy (MHT) After Menopause
  • Postmenopausal/Postmenopause Hormone Replacement Therapy (HRT)/Hormone Therapy (HT)

Revised Global Consensus Statement

What is one of the points of consensus about menopausal hormone therapy (MHT) and postmenopause?

One of the 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, is:

Hormone Therapy Postmenopause

  • “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”.2

What are vasomotor symptoms?

The International Menopause Society (IMS) explain:

“Hot flushes and night sweats are also referred to as Vasomotor Symptoms (VMS)”.3

Type and Timing of Menopausal Hormone Therapy and… Meta-Analysis

Hormone Therapy and Breast CancerHormone Therapy and Breast CancerWhat has feedback about Type and Timing of Menopausal Hormone Therapy and Breast Cancer Risk: Individual Participant Meta-Analysis of the Worldwide Epidemiological Evidence, published in the Lancet on 29 August 2019, included?

On page one in The International Menopause Society Comment on: “Type and Timing of Menopausal Hormone Therapy and Breast Cancer Risk: Individual Participant Meta-Analysis of the Worldwide Epidemiological Experience” the IMS elaborate on:

“Is there new information that menopausal hormone therapy (MHT) substantially increases breast cancer risk as suggested by a paper published in the Lancet this month and should women be worried?

  • Much of the information regarding breast cancer risk and MHT reported in this paper is not new…
  • It is important to note that, because of when the data included in this report was collected, most of the MHT regimes were different from those used today
  • This paper provides an important public health message about obesity and breast cancer risk…”.4

What do the IMS recommend?

On page two in The International Menopause Society Comment on: “Type and Timing of Menopausal Hormone Therapy and Breast Cancer Risk: Individual Participant Meta-Analysis of the Worldwide Epidemiological Experience” the IMS explain:

“Recommendations From the IMS

Women enter menopause across a range of ages, with diverse symptoms and health risk profiles. The International Menopause Society advocates the comprehensive assessment of women, including attention to modifying risk factors for chronic disease such as being overweight or obese, the importance of which have been highlighted in this Lancet paper. The benefits and risks of MHT differ according to the timing of menopause such that individualisation of therapy is essential. As prescribing practices have changed significantly over the last decade, further research is needed to determine the impact of currently recommended regimens”.5

In Menopause Experts Dismiss Some Breast Cancer Claims In New Report the (Australian) Jean Hailes for Women’s Health elaborate on:

“Australian menopause experts are urging women to talk to their doctor about their use of menopausal hormone therapy (MHT) if they have concerns following today’s publication of a large study linking MHT to an increased risk of breast cancer”.6

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Postmenopausal Bone Health

What are some points of consensus about MHT and postmenopausal bone health?

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

  • “MHT, including tibolone and CE/BZA, is effective in the prevention of bone loss in postmenopausal women
  • MHT has been shown to significantly lower the risk of hip, vertebral and other osteoporosis-related fractures in postmenopausal women
  • MHT, including tibolone, can be initiated in postmenopausal women at risk of fracture or osteoporosis before the age of 60 years or within 10 years after menopause”.7
What is CE/BZA?

CE/BZA can be an abbreviation for Conjugated Equine Estrogens/Bazedoxifene.

Over Age 60

If I am postmenopausal and over aged 60 years, do I need to stop hormone therapy (HT)?

On page one in the NAMS 2017 Position Statement Updates Guidelines for Hormone Therapy Use the North American Menopause Society note:

  • “For women who initiate HT more than 10 or 20 years from menopause onset or when aged 60 years or older, the benefit-risk ratio appears less favorable than for younger women because of greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia
  • 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 years for persistent hot flashes, quality-of-life issues, or prevention of osteoporosis after appropriate evaluation and counseling of benefits and risks”.8

Health Care Provider

What if I am postmenopausal and choose to use HT?

If you are postmenopausal and 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”.9

Health Topics A-Z

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Links

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Sources

Where may I find the Sources quoted?

You may find the Sources quoted at:

Sources

  1. 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: 20 June 2020
  2. 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: 20 June 2020
  3. Hot Flushes and Night Sweats – Background Information: What Are Hot Flushes and Night Sweats? October 2011:1. International Menopause Society https://www.imsociety.org/downloads/world_menopause_day_2011/wmd_media_backgrounder.pdf Accessed: 20 June 2020
  4. The International Menopause Society Comment on: “Type and Timing of Menopausal Hormone Therapy and Breast Cancer Risk: Individual Participant Meta-Analysis of the Worldwide Epidemiological Experience”. 29 August 2019:1. International Menopause Society https://www.imsociety.org/manage/images/pdf/2b650ccd4a2e0c63806d82ed2984ed69.pdf Accessed: 20 June 2020
  5. The International Menopause Society Comment on: “Type and Timing of Menopausal Hormone Therapy and Breast Cancer Risk: Individual Participant Meta-Analysis of the Worldwide Epidemiological Experience”. 29 August 2019:2. International Menopause Society https://www.imsociety.org/manage/images/pdf/2b650ccd4a2e0c63806d82ed2984ed69.pdf Accessed: 20 June 2020
  6. Menopause Experts Dismiss Some Breast Cancer Claims In New Report. 30 August 2019. Jean Hailes for Women’s Health https://jeanhailes.org.au/news/menopause-experts-dismiss-breast-cancer-claims-of-new-report Accessed: 20 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: 20 June 2020
  8. 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: 20 June 2020
  9. 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: 20 June 2020
Topic Last Updated: 20 June 2020 – Topic Last Reviewed:
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