European society of endocrinology clinical practice guideline for evaluation and management of menopause and the perimenopause

Eur J Endocrinol. 2025 Sep 30;193(4):G49-G81. doi: 10.1093/ejendo/lvaf206.

Abstract

Women make up 51% of the world's population, and the global population of postmenopausal women is growing. About 25% of these women experience debilitating menopausal symptoms. Since it is important that all health care professionals have a fundamental knowledge of managing women presenting with symptoms related to the menopause, this European Society of Endocrinology Clinical Practice Guideline was developed. It provides guidance on evaluation and optimal clinical management of women who go through the menopause in middle age, those with Premature Ovarian Insufficiency (POI), Early Menopause and those for whom hormones are not appropriate, including women with, or at high risk of, breast cancer. This guideline discusses the benefits and risks of hormone therapy administration as well as summarizing other treatments for menopausal symptoms. Further, the contentious issue of the impact of menopausal hormone therapy in the prevention of chronic disease is considered.

Keywords: hormone replacement therapy; menopausal hormone therapy; menopause; perimenopause; premature ovarian insufficiency.

Publication types

  • Practice Guideline

MeSH terms

  • Breast Neoplasms / prevention & control
  • Endocrinology* / standards
  • Estrogen Replacement Therapy
  • Europe
  • Female
  • Hormone Replacement Therapy
  • Humans
  • Menopause* / drug effects
  • Menopause* / physiology
  • Middle Aged
  • Perimenopause* / drug effects
  • Perimenopause* / physiology
  • Primary Ovarian Insufficiency / diagnosis
  • Primary Ovarian Insufficiency / therapy
  • Societies, Medical / standards