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Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline.
J Clin Endocrinol Metab. 2015 Nov; 100(11):3975-4011.JC

Abstract

OBJECTIVE

The objective of this document is to generate a practice guideline for the management and treatment of symptoms of the menopause.

PARTICIPANTS

The Treatment of Symptoms of the Menopause Task Force included six experts, a methodologist, and a medical writer, all appointed by The Endocrine Society.

EVIDENCE

The Task Force developed this evidenced-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews of published data and considered several other existing meta-analyses and trials.

CONSENSUS PROCESS

Multiple e-mail communications, conference calls, and one face-to-face meeting determined consensus. Committees of The Endocrine Society, representatives from endorsing societies, and members of The Endocrine Society reviewed and commented on the drafts of the guidelines. The Australasian Menopause Society, the British Menopause Society, European Menopause and Andropause Society, the European Society of Endocrinology, and the International Menopause Society (co-sponsors of the guideline) reviewed and commented on the draft.

CONCLUSIONS

Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric. Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT for cardiovascular and breast cancer risk and recommend the most appropriate therapy depending on risk/benefit considerations. Current evidence does not justify the use of MHT to prevent coronary heart disease, breast cancer, or dementia. Other options are available for those with vasomotor symptoms who prefer not to use MHT or who have contraindications because these patients should not use MHT. Low-dose vaginal estrogen and ospemifene provide effective therapy for the genitourinary syndrome of menopause, and vaginal moisturizers and lubricants are available for those not choosing hormonal therapy. All postmenopausal women should embrace appropriate lifestyle measures.

Authors+Show Affiliations

University of California, San Diego, Endocrine/Metabolism (C.A.S.), La Jolla, California 92093; Monash University, School of Public Health and Preventive Medicine (S.R.D.), Melbourne 03004, Australia; Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin Unit de Gynécologie Endocrnienne (A.G.), Paris 75014, France; University of Glasgow School of Medicine (M.A.L.), Glasgow G31 2ER, Scotland; Mayo Clinic, Division of Preventive Medicine (M.H.M.), Rochester, Minnesota 55905; University of Virginia, Obstetrics and Gynecology (J.V.P.), Charlottesville, Virginia 22908; and University of Virginia Health System (R.J.S.), Charlottesville, Virginia 22903.University of California, San Diego, Endocrine/Metabolism (C.A.S.), La Jolla, California 92093; Monash University, School of Public Health and Preventive Medicine (S.R.D.), Melbourne 03004, Australia; Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin Unit de Gynécologie Endocrnienne (A.G.), Paris 75014, France; University of Glasgow School of Medicine (M.A.L.), Glasgow G31 2ER, Scotland; Mayo Clinic, Division of Preventive Medicine (M.H.M.), Rochester, Minnesota 55905; University of Virginia, Obstetrics and Gynecology (J.V.P.), Charlottesville, Virginia 22908; and University of Virginia Health System (R.J.S.), Charlottesville, Virginia 22903.University of California, San Diego, Endocrine/Metabolism (C.A.S.), La Jolla, California 92093; Monash University, School of Public Health and Preventive Medicine (S.R.D.), Melbourne 03004, Australia; Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin Unit de Gynécologie Endocrnienne (A.G.), Paris 75014, France; University of Glasgow School of Medicine (M.A.L.), Glasgow G31 2ER, Scotland; Mayo Clinic, Division of Preventive Medicine (M.H.M.), Rochester, Minnesota 55905; University of Virginia, Obstetrics and Gynecology (J.V.P.), Charlottesville, Virginia 22908; and University of Virginia Health System (R.J.S.), Charlottesville, Virginia 22903.University of California, San Diego, Endocrine/Metabolism (C.A.S.), La Jolla, California 92093; Monash University, School of Public Health and Preventive Medicine (S.R.D.), Melbourne 03004, Australia; Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin Unit de Gynécologie Endocrnienne (A.G.), Paris 75014, France; University of Glasgow School of Medicine (M.A.L.), Glasgow G31 2ER, Scotland; Mayo Clinic, Division of Preventive Medicine (M.H.M.), Rochester, Minnesota 55905; University of Virginia, Obstetrics and Gynecology (J.V.P.), Charlottesville, Virginia 22908; and University of Virginia Health System (R.J.S.), Charlottesville, Virginia 22903.University of California, San Diego, Endocrine/Metabolism (C.A.S.), La Jolla, California 92093; Monash University, School of Public Health and Preventive Medicine (S.R.D.), Melbourne 03004, Australia; Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin Unit de Gynécologie Endocrnienne (A.G.), Paris 75014, France; University of Glasgow School of Medicine (M.A.L.), Glasgow G31 2ER, Scotland; Mayo Clinic, Division of Preventive Medicine (M.H.M.), Rochester, Minnesota 55905; University of Virginia, Obstetrics and Gynecology (J.V.P.), Charlottesville, Virginia 22908; and University of Virginia Health System (R.J.S.), Charlottesville, Virginia 22903.University of California, San Diego, Endocrine/Metabolism (C.A.S.), La Jolla, California 92093; Monash University, School of Public Health and Preventive Medicine (S.R.D.), Melbourne 03004, Australia; Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin Unit de Gynécologie Endocrnienne (A.G.), Paris 75014, France; University of Glasgow School of Medicine (M.A.L.), Glasgow G31 2ER, Scotland; Mayo Clinic, Division of Preventive Medicine (M.H.M.), Rochester, Minnesota 55905; University of Virginia, Obstetrics and Gynecology (J.V.P.), Charlottesville, Virginia 22908; and University of Virginia Health System (R.J.S.), Charlottesville, Virginia 22903.University of California, San Diego, Endocrine/Metabolism (C.A.S.), La Jolla, California 92093; Monash University, School of Public Health and Preventive Medicine (S.R.D.), Melbourne 03004, Australia; Université Paris Descartes, Hôpitaux Universitaires Port Royal-Cochin Unit de Gynécologie Endocrnienne (A.G.), Paris 75014, France; University of Glasgow School of Medicine (M.A.L.), Glasgow G31 2ER, Scotland; Mayo Clinic, Division of Preventive Medicine (M.H.M.), Rochester, Minnesota 55905; University of Virginia, Obstetrics and Gynecology (J.V.P.), Charlottesville, Virginia 22908; and University of Virginia Health System (R.J.S.), Charlottesville, Virginia 22903.

Pub Type(s)

Journal Article
Practice Guideline
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26444994

Citation

Stuenkel, Cynthia A., et al. "Treatment of Symptoms of the Menopause: an Endocrine Society Clinical Practice Guideline." The Journal of Clinical Endocrinology and Metabolism, vol. 100, no. 11, 2015, pp. 3975-4011.
Stuenkel CA, Davis SR, Gompel A, et al. Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100(11):3975-4011.
Stuenkel, C. A., Davis, S. R., Gompel, A., Lumsden, M. A., Murad, M. H., Pinkerton, J. V., & Santen, R. J. (2015). Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology and Metabolism, 100(11), 3975-4011. https://doi.org/10.1210/jc.2015-2236
Stuenkel CA, et al. Treatment of Symptoms of the Menopause: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2015;100(11):3975-4011. PubMed PMID: 26444994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline. AU - Stuenkel,Cynthia A, AU - Davis,Susan R, AU - Gompel,Anne, AU - Lumsden,Mary Ann, AU - Murad,M Hassan, AU - Pinkerton,JoAnn V, AU - Santen,Richard J, Y1 - 2015/10/07/ PY - 2015/10/8/entrez PY - 2015/10/8/pubmed PY - 2016/2/26/medline SP - 3975 EP - 4011 JF - The Journal of clinical endocrinology and metabolism JO - J Clin Endocrinol Metab VL - 100 IS - 11 N2 - OBJECTIVE: The objective of this document is to generate a practice guideline for the management and treatment of symptoms of the menopause. PARTICIPANTS: The Treatment of Symptoms of the Menopause Task Force included six experts, a methodologist, and a medical writer, all appointed by The Endocrine Society. EVIDENCE: The Task Force developed this evidenced-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews of published data and considered several other existing meta-analyses and trials. CONSENSUS PROCESS: Multiple e-mail communications, conference calls, and one face-to-face meeting determined consensus. Committees of The Endocrine Society, representatives from endorsing societies, and members of The Endocrine Society reviewed and commented on the drafts of the guidelines. The Australasian Menopause Society, the British Menopause Society, European Menopause and Andropause Society, the European Society of Endocrinology, and the International Menopause Society (co-sponsors of the guideline) reviewed and commented on the draft. CONCLUSIONS: Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric. Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT for cardiovascular and breast cancer risk and recommend the most appropriate therapy depending on risk/benefit considerations. Current evidence does not justify the use of MHT to prevent coronary heart disease, breast cancer, or dementia. Other options are available for those with vasomotor symptoms who prefer not to use MHT or who have contraindications because these patients should not use MHT. Low-dose vaginal estrogen and ospemifene provide effective therapy for the genitourinary syndrome of menopause, and vaginal moisturizers and lubricants are available for those not choosing hormonal therapy. All postmenopausal women should embrace appropriate lifestyle measures. SN - 1945-7197 UR - https://www.unboundmedicine.com/medline/citation/26444994/Treatment_of_Symptoms_of_the_Menopause:_An_Endocrine_Society_Clinical_Practice_Guideline_ L2 - https://academic.oup.com/jcem/article-lookup/doi/10.1210/jc.2015-2236 DB - PRIME DP - Unbound Medicine ER -