Management of Menopausal Symptoms

Area of Science:

• Reproductive Endocrinology
• Menopause Management
• Women's Health

Background:

• Vasomotor symptoms affect most menopausal women, often persisting for over a decade.
• Hormone therapy (HT) is the most effective treatment for these symptoms.
• Genitourinary syndrome of menopause significantly impacts quality of life.

Purpose of the Study:

• To review the benefits and risks of hormone therapy (HT) for menopausal symptoms.
• To discuss personalized risk assessment for optimizing HT safety and efficacy.
• To highlight effective treatments for genitourinary syndrome of menopause.

Main Methods:

• Review of findings from the Women's Health Initiative and other randomized clinical trials.
• Analysis of benefits and risks associated with oral and transdermal estrogen formulations.
• Evaluation of low-dose vaginal estrogen and FDA-approved nonhormonal options.

Main Results:

• HT, including combination estrogen-progestin and estrogen-alone, shows comparable efficacy.
• Absolute risks with HT are generally small, particularly in younger women with lower cardiovascular risk.
• Low-dose vaginal estrogen is highly effective for genitourinary syndrome of menopause.

Conclusions:

• Personalized risk assessment and patient preferences are crucial for optimizing HT benefit-risk profiles.
• Systemic HT duration should be individualized, not arbitrarily stopped at age 65.
• FDA-approved HT and treatments are preferred over custom-compounded hormones due to tested efficacy and safety.