2016 IMS Recommendations on women’s midlife health and menopause hormone therapy

Abstract

The International Menopause Society (IMS) has produced these new 2016 recommendations on women’s midlife health and menopause hormone therapy (MHT) to help guide health-care professionals in optimizing their management of women in the menopause transition and beyond. The term MHT has been used to cover therapies including estrogens, progestogens and combined regimens. For the first time, the 2016 IMS recommendations now include grades of recommendations, levels of evidence and 'good practice points', in addition to section-specific references. Where possible, the recommendations are based on and linked to the evidence that supports them, unless good-quality evidence is absent. Particular attention has been paid to published evidence from 2013 onwards, the last time the IMS recommendations were updated. Databases have been extensively searched for relevant publications using key terms specific to each specialist area within menopause physiology and medicine. Information has also been drawn from international consensus statements published by bodies such as the IMS, the European Menopause and Andropause Society and the North American Menopause Society. The recommendations have been produced by experts derived mainly from the IMS, with the assistance of key collaborators where deemed advantageous. In preparing these international recommendations, experts have taken into account geographical variations in medical care, prevalence of diseases, and country-specific attitudes of the public, medical community and health authorities towards menopause management. The variation in availability and licensing of MHT and other products has also been considered.

Keywords:

• Menopause hormone therapy
• midlife health
• IMS
• hormone replacement therapy
• HRT
• Recommendations

The Writing Group for the Recommendations

A summary of Declarations of interest in the past 2 years is listed below. A more detailed list is available on the IMS website.

R. J. Baber

Obstetrics and Gynaecology, Sydney Medical School North, The University of Sydney, Sydney, Australia

Advisory Board and/or Consultant: Pfizer

Speaker’s Bureau: Abbott

N. Panay

Imperial College London, UK, Co-Editor-in-Chief, Climacteric

Advisory Board and/or Consultant: Abbott, Bayer, Besins, Novo Nordisk, Pfizer, Shionogi

Speaker’s Bureau: Abbott, Bayer, Besins, Novo Nordisk

A. Fenton

Christchurch Women's Hospital, Christchurch, New Zealand, Co-Editor-in-Chief, Climacteric

Advisory Board and/or Consultant: Pfizer

Speaker’s Bureau: Besins, Mylan

L. Cardozo

Professor of Urogynaecology, King’s College Hospital, London, UK

Advisory Board and/or Consultant: Astellas, BMR, Golin Health

Speaker’s Bureau: Allergan, Astellas

Grant/research support: Pfizer

C. Castelo-Branco

Clinic Institute of Gynecology, Obstetrics and Neonatology, Faculty of Medicine, University of Barcelona, Barcelona, Spain

Advisory Board and/or Consultant: Pierre Fabre, Shionogi

Speaker’s Bureau: Amgem, Isdin, Pfizer, Pierre Fabre, Shionogi

S. R. Davis

Women’s Health Research Program, Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia

Advisory Board and/or Consultant: Abbott International, Pfizer, Acerus Pharmaceuticals

Grant/research support: Lawley Pharmaceuticals

T. J. de Villiers

MediClinic Panorama and Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa

Advisory Board and/or Consultant: Adcock Ingram Ltd, Merck, Pfizer

Speaker's Bureau: Adcock Ingram Ltd, Pfizer

S. R. Goldstein

Department of Obstetrics and Gynecology, New York University School of Medicine, New York, NY, USA

Advisory Board and/or Consultant: AbbVie, Amgen, Cook ObGyn, JDS Therapeutics, Pfizer, Radius Health Inc, Sermonix Pharmaceuticals, Shionogi Ltd

Speaker’s Bureau: JDS Therapeutics, Pfizer and Shionogi

Equipment loan as a consultant: Philips Ultrasound

A. Gompel

UF de Gynécologie, Université Paris Descartes, AP-HP, Hopitaux Paris Centre, Port Royal Cochin, INSERM U1007, Paris, France

No relevant financial relationships

V. W. Henderson

Departments of Health Research & Policy (Epidemiology) and of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA

Grant/research support: NIH

Travel reimbursement: American Academy of Neurology, International Menopause Society to participate in meetings of society committees

H. N. Hodis

Atherosclerosis Research Unit, Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, USA

Grant/research support: NIH as Principal investigator

R. D. Langer

Associate Dean for Clinical and Translational Research and Professor of Family Medicine-Las Vegas, University of Nevada School of Medicine, Las Vegas, NV, USA

Litigation consultant: Roche Pharmaceuticals

R. A. Lobo

Department of Obstetrics and Gynecology, Columbia University, New York, NY, USA

Speaker’s Bureau: Pfizer

Grant/research support: Therapeutics MD

P. M. Maki

Departments of Psychiatry and Psychology, University of Illinois at Chicago, USA

Speaker’s Bureau: Abbott, Noven

A. O. Mueck

Department of Women's Health, Germany and Capital Medical University, Beijing OB/GYN Hospital, WHO Centre, China

No relevant financial relationships

R. E. Nappi

Research Center for Reproductive Medicine, Gynecological Endocrinology and Menopause, IRCCS S. Matteo Foundation, University of Pavia, Pavia, Italy

Advisory Board and/or Consultant: Bayer HealthCare, Gedeon Richter, Merck Sharpe & Dohme, Shionogi Ltd

Speaker’s Bureau: Novo Nordisk, Pfizer, Shionogi Ltd, TEVA Women's Health Inc

Grant/research support: Bayer HealthCare

A. Pines

Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

No relevant financial relationships

G. Plu-Bureau

Department of Gynecology, Hopitaux Universitaires Paris Centre, Paris Descartes University, Paris, France

No relevant financial relationships

D. Robinson

Department of Urogynaecology, King's College Hospital, London, UK

Advisory Board and/or Consultant: Astellas, Pfizer, Allergan, Ferring

Speaker’s Bureau: Astellas, Pfizer, Allergan

Grant/research support: Astellas, Pfizer, Allergan

T. Simoncini

Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy

Advisory Board and/or Consultant: Abbott, Actavis

Speaker’s Bureau: Abbott, Actavis

S. Z. Vujovic

Medical Faculty, University of Belgrade and Clinic of Endocrinology, Diabetes and Diseases of Metabolism, Clinical Center of Serbia, Belgrade, Serbia

No relevant financial relationships

Source of funding

The costs of writing this paper have been supported entirely from the funds of the International Menopause Society.

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