Hormone Therapy: Updated Position Statement Released

By Joe Elia

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The North American Menopause Society has updated its position on the risks and benefits of hormone therapy.

The 26-page statement evaluates new findings made since the 2012 edition. Among the guidelines that were rated high "based on good and consistent" evidence:

• Hormone therapy (HT) represents the "most effective treatment" for vasomotor symptoms and the genitourinary syndrome of menopause.

• HT's symptomatic benefits are most likely to outweigh risks when begun at age 60 or younger, or within 10 years of the onset of menopause.

• In alleviating genitourinary symptoms, low-dose vaginal estrogen therapy is favored over systemic therapy.

• Clinicians should discuss with the patient the risks of heart disease and all-cause mortality, which are generally greater if HT is started more than 10 years after menopause onset or after age 60.

The authors note: "There are no data to support routine discontinuation in women aged 65 years."