Hormone Therapy Update June 2022

Hormone Therapy Update June 2022 showcases some information published in June (and July) 2022, about making an informed decision whether to take hormone therapy.

Hormone Therapy

What is hormone therapy (HT)?

Depending on the Source the definition of HT may vary. In Menopause Management: Menopausal Hormone Therapy (MHT) – What Is MHT? the (Australian) Jean Hailes for Women’s Health’s definition is:

“Menopausal Hormone Therapy (MHT), formerly known as Hormone Replacement Therapy (HRT) and hormone therapy (HT), is the medical replacement of the female hormones oestrogen and progesterone, and sometimes testosterone. MHT is a treatment used to help manage menopausal symptoms, such as hot flushes and night sweats, when they are interfering with your life”.

Looking At HRT In Perspective

What does Looking At HRT In Perspective, published in the British Medical Journal (BMJ) 15 June 2022, include about HT?

In Looking At HRT In Perspective: Helping Women Make Informed Decisions the BMS elaborate on:

“The main indication for HRT remains control of problematic menopausal symptoms and improving quality of life. Evidence from randomised trials shows clear benefits in this context,⁵ and no arbitrary limits should be placed on duration of use.¹ ² ⁴ HRT may help relieve short term cognitive symptoms related to the menopause, but this should be clearly differentiated from dementia prevention. Evidence does not support use of HRT to reduce the risk of dementia¹ ² ⁴ ⁶ ⁷”.

Looking At HRT In Perspective: Breast Cancer

What does Looking At HRT In Perspective, published in the BMJ 15 June 2022, include about HT and the risk of breast cancer?

In Looking At HRT In Perspective: Helping Women Make Informed Decisions the BMS explain:

“The risk of breast cancer associated with HRT remains a concern for many women. Current evidence suggests that oestrogen only formulations are associated with little or no change in the risk of breast cancer, while combined HRT (oestrogen plus a progestogen) can be associated with an increased risk. This appears duration dependent and may vary with the type of progestogen used¹ ⁸ ⁹ ¹⁰. However, the risk is low (absolute excess risk of breast cancer over 10 years is 3-7/1000 women taking combined HRT for up to 5 years),¹⁰ particularly compared with risks associated with other modifiable risk factors such as obesity and alcohol intake”.

Joint Position Statement

What does 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 in Post Reproductive Health 10 June 2022, include about HT?

In 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 the 22 recommendations and more, include:

“The aim of this Position Statement is to provide evidence-based recommendations on best practice in line with current national and international guidelines and recommendations.

Our recommendations are as follows:

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”.

2022 Hormone Therapy Position Statement of The NAMS

What does The 2022 Hormone Therapy Position Statement of The North American Menopause Society, published in Menopause, The Journal of The North American Menopause Society, July 2022, note about HT?

In The 2022 Hormone Therapy Position Statement of The North American Menopause Society the North American Menopause Society (NAMS) note:

“Hormone therapy remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause and has been shown to prevent bone loss and fracture. The risks of hormone therapy differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing therapy”.

Hormone Therapy: Understanding the Risks and Benefits Video

What is the North American Menopause Society (NAMS) latest video, Hormone Therapy: Understanding the Risks and Benefits?

In Video Series-2022 the NAMS explain:

“In this latest video, Hormone Therapy: Understanding the Risks and Benefits, Dr. Shapiro interviews Dr. Jewel Kling, Professor of Medicine; Chair, Women’s Health Internal Medicine; and Associate Chair of Equity, Inclusion, and Diversity, Department of Medicine at the Mayo Clinic in Scottsdale, Arizona”.

Optimising the Menopause Transition

What does the position statement Optimising the Menopause Transition: 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 in Post Reproductive Health 10 June 2022, include about HT?

In Optimising the Menopause Transition: 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 the authors elaborate on:

“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, and no arbitrary limits should be set on age or duration of HRT intake. For most women, HRT has a favourable benefit/risk profile. However, HRT should not be used without a clear indication and should not be used for the sole purpose of disease prevention. Menopause is a life stage and does not represent a deficiency state”.

Health Care Provider

What if I need help deciding whether to take HT?

If you need help deciding whether to take HT it may be in your best interest to choose to discuss this with you health care provider.

In Looking At HRT In Perspective: Benefits the BMS explain:

“Access to accurate information about the menopause, and to help and support from reliable sources, makes women better placed to manage the menopause transition and improve their quality of life. Healthcare providers should take an individualised approach to assessment and empower women to make informed decisions based on unbiased, evidence based information applied effectively. Nobody should be suffering in silence or feel that the effect of the menopause is not adequately recognised”.

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