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Published on: August 13, 2019
Postmenopausal hormone therapy: an Endocrine Society scientific statement
Richard J Santen1, D Craig Allred, Stacy P Ardoin
1Division of Endocrinology and Metabolism, University of Virginia, Charlottesville, Virginia 22908, USA. RJS5Y@VIRGINIA.EDU
The Journal of Clinical Endocrinology and Metabolism
|June 23, 2010
Summary
Menopausal hormonal therapy (MHT) offers benefits like hot flash relief and fracture prevention, but carries risks such as blood clots and stroke. Early MHT use in younger women shows potential for reduced mortality and heart disease, though breast cancer risk varies.
Area of Science:
- Endocrinology
- Women's Health
- Menopause Management
Background:
- Menopausal hormonal therapy (MHT) is widely used for symptom management.
- Evidence on MHT's risks and benefits requires scholarly review and grading.
- The Endocrine Society convened a task force to assess MHT literature.
Purpose of the Study:
- To conduct a scholarly review of MHT literature.
- To scientifically assess available MHT data and grade evidence levels.
- To evaluate clinically important endpoints of MHT.
Main Methods:
- Literature search of case-control, cohort, and randomized controlled trials.
- Inclusion of meta-analyses, Cochrane reviews, and professional society statements.
- Evidence grading using the GRADE system and multi-level peer review.
Main Results:
- MHT provides benefits including relief of hot flashes, urogenital atrophy symptoms, and prevention of fractures and diabetes.
- Risks associated with MHT include venothrombotic episodes, stroke, and cholecystitis.
- Early MHT initiation (ages 50-59) may reduce mortality and coronary artery disease, but breast cancer risk increases with certain progestogens.
Conclusions:
- MHT's benefits and risks vary based on initiation time and formulation.
- Data from older populations (Women's Health Initiative) are not directly applicable to younger women starting MHT.
- Evidence for MHT benefits and risks in younger women is based on lower-level data.
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