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Hormone Therapy for First-Line Management of Menopausal Symptoms: Practical Recommendations


Hormone Therapy for First-Line Management of Menopausal Symptoms: Practical Recommendations

Santiago Palacios et al. Womens Health (Lond).


Hormone therapy use has undergone dramatic changes over the past 20 years. Widespread use of hormone therapy in the 1980s and 1990s came to an abrupt halt in the early 2000s after initial findings of the Women's Health Initiative trial were published and the study was terminated. Since then, much has been learned about the characteristics of women most likely to benefit from hormone therapy. There is general agreement that women younger than 60 years or who initiate hormone therapy within 10 years of menopause onset gain short-term benefit in terms of symptomatic relief and long-term benefit in terms of protection from chronic diseases that affect postmenopausal women. Despite accumulating evidence in support of hormone therapy for symptomatic menopausal women, the slow response by the medical community has led to a 'large and unnecessary burden of suffering' by women worldwide. Greater efforts are clearly needed to educate physicians and medical students about the pathophysiology of menopause and the role of hormone therapy in supporting women through the transition. This article provides a brief historical perspective of events that led to the backlash against hormone therapy, explores the current position of guideline groups, and provides practical recommendations to guide first-line management of symptomatic menopausal women.

Keywords: breast cancer; guidelines; hormone therapy; menopause; venous thromboembolism; women’s health.

Conflict of interest statement

Declaration of conflicting interests: SP has served as symposium speaker or advisory board member for Abbott, Amgen, Bioiberica, Candel, Ferrer, Gedeon Richter, Mylan, Pfizer, Procare, Seid, Servier and Shionogi, and has received research grants and/or consulting fees from Amgen, Bayer, Gynea, Leon Farma, Pfizer, Preglem, Sandoz and Servier. JCS has received grants and research support from Abbott, Mylan and Pfizer; has received speakers’ honoraria from Abbott, Bayer, Gedeon Richter, Menarini, Mylan and Pfizer; and has received consulting fees from Abbott, Mylan and Pfizer. KS has served as symposium speaker or advisory board member for Bayer-Jenapharm GmbH; Dr. KADE/Besins Pharma GmbH; Exeltis GmbH; Gedeon Richter Pharma GmbH; Hexal; Laborarztpraxis Dres. Walther, Weindel and Partners; Merck Sharp & Dohme GmbH; Mylan Dura GmbH; Rottapharm; Santen and Shionogi & Co., Ltd. ML has nothing to declare. AG has received speakers’ bureau from Alfa Wassermann, Angelina, Bayer, Berlin-Chemie, Biofemme, Italfarmaco, Gedeon Richter, Lolipharm, Recordati, Shionogi, Teva, Theramax and Zambon; has served on advisory boards for Alfa Wassermann, Angelina, Mylan and Shionogi; and has acted as consultant for Alfa Wassermann, Angelina, Bayer, Italfarmaco, Gedeon Richter, Lolipharm, Recordati, Shionogi and Zambon.

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