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Climacteric Volume 11, 2008 - Issue 2
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Recommendations

Updated practical recommendations for hormone replacement therapy in the peri- and postmenopause

Updated Recommendations Group Chair M. H. Birkhäuser , Switzerland
,
Updated Recommendations Group Chair M. H. Birkhäuser , Switzerland
,
Secretary N. Panay , UK
,
D. F. Archer , USA
,
D. Barlow , UK
,
H. Burger , Australia
,
M. Gambacciani , Italy
,
S. Goldstein , USA
,
J. A. Pinkerton , USA
&
D. W. Sturdee , UK
 show all
Pages 108-123 | Received 28 Nov 2007, Accepted 13 Feb 2008, Published online: 03 Jul 2009

Key references (by section)

Recommendations and IMS Statements

  • IMS Updated Recommendations on postmenopausal hormone therapy. Climacteric 2007;10:181–94
  • Guidelines for the hormone treatment of women in the menopausal transition and beyond. Position Statement by the Executive Committee of the International Menopause Society. Climacteric 2004;7:333–7
  • Burger H, Archer D, Barlow D, et al. Practical recommendations for hormone replacement therapy in the peri- and postmenopause. Climacteric 2004; 7: 210–16
  • Burger H G. WHI risks: any relevance to menopause management?. Maturitas 2007; 57: 6–10
  • Gambacciani M, Genazzani A R. Hormone replacement therapy: the benefits in tailoring the regimen and dose. Maturitas 2001; 40: 195–201
  • Grodstein F, Manson J A, Colditz G A, Willett W C, Speizer F E, Stampfer M J. A prospective observational study of postmenopausal hormone therapy on primary prevention of cardiovascular disease. Ann Intern Med 2000; 133: 933–41
  • Hickey M, Davis S, Sturdee D. Treatment of menopausal symptoms: what shall we do now?. Lancet 2005; 366: 409–21
  • Jick H, Derby L E, Myers M W, Vasilakis C, Newton K M. Risk of hospital admission for idiopathic venous thromboembolism among users of postmenopausal oestrogen. Lancet 1996; 348: 981–3
  • Pines A, Sturdee D W, Birkhäuser M H, Schneider H PG, Gambacciani M, Panay N. IMS Updated Recommendations on postmenopausal hormone therapy. Climacteric 2007; 10: 181–94
  • Panay N, Ylikorkala O, Archer D F, Gut R, Lang E. Ultra-low-dose estradiol and norethisterone acetate: effective menopausal symptom relief. Climacteric 2007; 10: 120–31
  • Salpeter S R, Walsh J M, Greyber E, Ormiston T M, Salpeter E E. Mortality associated with hormone replacement therapy in younger and older women: a meta-analysis. J Gen Intern Med 2004; 19: 791–804
  • Sturdee D W, Archer D F, Rakov V, et al. Ultra-low-dose continuous combined estradiol and norethisterone acetate: improved bleeding profile in postmenopausal women. Climacteric 2008; 11: 63–73

Postmenopausal osteoporosis

  • Greenwald M W, Gluck O S, Lang E, Rakov V. Oral hormone therapy with 17beta-estradiol and 17beta-estradiol in combination with norethindrone acetate in the prevention of bone loss in early postmenopausal women: dose-dependent effects. Menopause 2005; 12: 741–8
  • Bone H G, Hosking D, Devogelaer J P, et al. Ten years' experience with alendronate for osteoporosis in postmenopausal women. N Engl J Med 2004; 350: 1189–99
  • Cauley J A, Robbins J, Chen Z, et al. Effects of estrogen plus progestin on risk of fracture and bone mineral density: the Women's Health Initiative randomized trial. JAMA 2003; 290: 1729–38
  • Ettinger B, Ensrud K E, Wallace R, et al. Effects of ultra low-dose transdermal estradiol on bone mineral density: a randomized clinical trial. Obstet Gynecol 2004; 104: 443–51
  • Ott S. Long term safety of bisphosphonates. J Clin Endocrinol Metab 2005; 90: 1897–9

Effect on coronary heart disease

  • American Association of Clinical Endocrinologists. Position Statement on Hormone Replacement Therapy (HRT) and Cardiovascular Risk 2007, www.aace.com
  • Grodstein F, Manson J E, Stampfer M J. Hormone therapy and coronary heart disease: the role of time since menopause and age at hormone initiation. J Womens Health 2006; 15: 35–44
  • Harman S M, Brinton E A, Cedars M, et al. KEEPS: The Kronos Early Estrogen Prevention Study. Climacteric 2005; 8: 3–12
  • Hsia J, Langer R D, Manson J E, et al. Conjugated equine estrogens and coronary heart disease: the Women's Health Initiative. Arch Intern Med 2006; 166: 357–65
  • Lobo R A, Bush T, Carr B R, Pickar J H. Effects of lower doses of conjugated equine estrogens and medroxyprogesterone acetate on plasma lipids and lipoproteins, coagulation factors, and carbohydrate metabolism. Fertil Steril 2001; 76: 13–24
  • Lobo R A. Postmenopausal hormones and coronary artery disease: potential benefits and risks. Climacteric 2007; 10(Suppl 2)21–26
  • Manson J E, Allison M A, Rossouw J E, et al. Estrogen therapy and coronary-artery calcification. N Engl J Med 2007; 356: 2591–602
  • Rossouw J E, Prentice R L, Manson J E, et al. Postmenopausal hormone therapy and risk of cardiovascular disease by age and years since menopause. JAMA 2007; 297: 1465–77
  • Writing Group for the Women's Health Initiative Investigators. Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women's Health Initiative randomized controlled trial. JAMA 2002; 288: 321–33

Effect on venous thromboembolism and stroke

  • Lobo R A. Menopause and stroke and the effects of hormone therapy. Climacteric 2007; 10(Suppl 2)27–31
  • Canonico M, Plu-Bureau G, Conard J, et al. Hormone therapy and venous thromboembolism among postmenopausal women. Circulation 2007; 115: 840–5

Other effects

  • Collins P, Rosano G, Casey C, et al. Management of cardiovascular risk in the peri-menopausal woman: a consensus statement of European cardiologists and gynaecologists. Eur Heart J 2007; 28: 2028–40
  • Gambacciani M, Pepe A, Cappagli B, Palmieri E, Genazzani A R. The relative contributions of menopause and aging to postmenopausal reduction in intervertebral disk height. Climacteric 2007; 10: 298–305

Other hormonal treatments

  • Archer D F, Hendrix S, Ferenczy A, et al. Tibolone histology of the endometrium and breast endpoints study: design of the trial and endometrial histology at baseline in postmenopausal women. Fertil Steril 2006; 88: 866–78
  • Cummings S R. LIFT study is discontinued (Letter to the Editor). BMJ 2006; 332: 667
  • Kenemans P, Speroff L. International Tibolone Consensus Group. Tibolone: clinical recommendations and practical guidelines. A report of the International Tibolone consensus Group. Maturitas 2005; 51: 21–28
  • Lewiecki E M. Bazedoxifene and bazedoxifene combined with conjugated estrogens for the management of postmenopausal osteoporosis. Expert Opin Investig Drugs 2007; 16: 1663–72

Androgens

  • Buster J E, Kingsberg S A, Aguirre O, et al. Testosterone patch for low sexual desire in surgically menopausal women: a randomized trial. Obstet Gynecol 2005; 105: 944–52
  • Shifren J L, Davis S R, Moreau M, et al. Testosterone patch for the treatment of hypoactive sexual desire disorder in naturally menopausal women: results from the INTIMATE NM1 study. Menopause 2006; 13: 770–9
  • Simon J, Braunstein G, Nachtigall L, et al. Testosterone patch increases sexual activity and desire in surgically menopausal women with hypoactive sexual desire disorder. J Clin Endocrinol Metab 2005; 90: 5226–33
  • Swerdloff R S, Wang C. Dihydrotestosterone: a rationale for its use as a non-aromatizable androgen replacement therapeutic agent. Baillieres Clin Endocrinol Metab 1998; 12: 501–6

Other non-hormonal treatments

  • Butt D A, Lock M, Lewis J E, Ross, Moineddin R. Gabapentin for the treatment of menopausal hot flashes: a randomized controlled trial. Menopause Oct 2, 2007, Epub ahead of print
  • Bouchard P, Archer D F, Panay N, Olivier S, Bessac L. Desvenlafaxine succinate is an effective treatment for menopausal vasomotor symptoms: a review of 3 clinical trials. Amsterdam Menopause Symposium June, 2007, Abstract
  • Panay N, Rees M. The use of alternatives to HRT for the management of menopause symptoms. RCOG Scientific Advisory Committee Opinion Paper no 6, 2006. www.rcog.org.uk.
  • Suvanto-Luukkonen E, Koivunen R, Sundstrom H, et al. Citalopram and fluoxetine in the treatment of postmenopausal symptoms: a prospective, randomized, 9-month, placebo-controlled, double-blind study. Menopause 2005; 12: 18–26
  • Nelson H D, Vesco K K, Haney E, et al. Non-hormonal therapies for menopausal hot flashes: systematic review and meta-analysis. JAMA 2006; 295: 2057–71

Phytoestrogens and herbs

  • Coon J T, Pittler M H, Ernst E. Trifolium pratense isoflavones in the treatment of menopausal hot flushes: a systematic review and meta-analysis. Phytomedicine 2007; 14: 153–9
  • Nelson H D, Vesco K K, Haney E, et al. Non hormonal therapies for menopausal hot flashes: systematic review and meta-analysis. JAMA 2006; 295: 2057–71
  • Panay N. Integrating phytoestrogens with prescription medicines – a conservative clinical approach to vasomotor symptom management. Maturitas 2007; 57: 90–94

Breast cancer

  • Anderson G L, Chlebowski R T, Rossouw J, et al. Prior hormone therapy and breast cancer risk in the Women's Health Initiative randomized trial of estrogen plus progestin. Maturitas 2006; 55: 103–15
  • Bluming A Z. Hormone replacement therapy: the debate should continue. Geriatrics 2004; 59: 35–37
  • Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and hormone replacement therapy: collaborative reanalysis of data from 51 epidemiological studies of 52,705 women with breast cancer and 108,411 women without breast cancer. Lancet 1997; 350: 1047–59
  • Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat Feb 27, 2007, Epub ahead of print
  • Lundström E, Bygdeson M, Svane G, Azavedo E, von Schoultz B. Neutral effect of ultra-low-dose continuous combined estradiol and norethisterone acetate on mammographic breast density. Climacteric 2007; 10: 249–56
  • Million Women Study Collaborators. Breast cancer and HRT in the Million Women Study. Lancet 2003; 362: 419–27
  • Ravdin P M, Cronin K A, Howlader N, et al. The Decrease in breast cancer incidence in 2003 in the United States. N Engl J Med 2007; 356: 1670–74
  • Stefanick M L, Anderson G L, Margolis K L, et al. Effects of conjugated equine estrogens on breast cancer and mammography screening in postmenopausal women with hysterectomy. JAMA 2006; 295: 1647–57

Endometrial cancer

  • Million Women Study Collaborators. Endometrial cancer and hormone-replacement therapy in the Million Women Study. Lancet 2005; 365: 1543–51
  • Raudaskoski T, Tapanainen J, Tom´s E, et al. Intrauterine 10 microg and 20 microg levonorgestrel systems in postmenopausal women receiving oral oestrogen replacement therapy: clinical, endometrial and metabolic response. Br J Obstet Gynaecol 2002; 109: 136–44
  • Weiderpass E, Adami H O, Baron J A, et al. Risk of endometrial cancer following estrogen replacement with and without progestins. J Natl Cancer Inst 1999; 91(13)1131–7

Ovarian cancer

  • Greiser CM, Greiser EM, Dören M. Menopausal hormone therapy and risk of ovarian cancer: systematic review and meta-analysis. Hum Reprod Update 2007;13:453–63.
  • Lacey J V, Jr, Brinton L A, Leitzmann M F. Menopausal hormone therapy and ovarian cancer risk in the National Institutes of Health-AARP Diet and Health Study Cohort. J Natl Cancer Inst 2006; 98: 1397–405

Other cancers

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