Effectiveness and safety of menopause treatments: pitfalls of available evidence and future research need

Abstract

By 2050 more than 1.6 billion women worldwide will be of post-reproductive age, with >75% reporting severe menopausal symptoms. The last few years saw a gradual uplift in public awareness reaffirming the health needs of women with menopause. Still, effective translation of available evidence on menopause treatments is hindered by several methodological limitations and poor research conduct. We argue that a paradigm shift is required in menopause research to address the remaining knowledge gap and guide safe evidence-based care provision. A critical misconception across studies on menopause is the assumption that women represent a homogeneous group who respond similarly to a particular therapy irrespective of their exposure and individual risk factors. We highlight potential solutions to optimize the quality of future research in menopause including adopting robust trial methodology, standardize outcome reporting to capture quality-of-life measures, and improve lay patient and public involvement in future research.

摘要

到2050年, 全球将有超过16亿女性进入育龄期后的阶段, 其中75%以上的妇女报告有严重的绝经症状。在过去几年中, 公众意识逐步提高, 重申了绝经女性的健康需求。尽管如此, 关于绝经治疗的现有证据的有效性转变仍然受到几个方法限制和糟糕的研究的阻碍。我们认为, 绝经的研究模式需要转变以解决存在的知识差距并指导安全的循证护理。在有关绝经的研究中, 一个关键的误解是假定女性是一个相同的群体, 她们对特定治疗的反应相似, 而不考虑她们的暴露和个人风险因素。我们强调潜在解决方案以优化未来绝经相关研究的质量, 包括采用稳健的试验方法, 标准化结局报告以获取生活质量指标, 以及在未来的研究中提升患者和公众的参与。

Keywords:

• Menopause
• hormonal therapy
• evidence synthesis
• patient involvement
• research priorities