A statement was released recently from the American Society for Reproductive Medicine, the North American Menopause Society, and the Endocrine Society regarding the use of hormone therapy for symptomatic menopausal women. Over the past 10 years, there has been a lot of confusion among experts regarding hormone therapy which led many women to believe it may not be safe. The purpose of the statement is to reassure women and their providers that hormone therapy is “…acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women.”
“After 10 years of debate regarding the risks and benefits of hormone therapy, 15 top medical organizations have come together to issue a statement of agreement regarding the benefits of hormone therapy for symptomatic menopausal women. It was July 9, 2002, when the controversial, highly publicized Women’s Health Initiative (WHI) published its assessment of hormone therapy for the prevention of chronic disease and concluded that risks exceeded benefits. The new joint statement, prepared by The North American Menopause Society (NAMS), the American Society for Reproductive Medicine (ASRM), and The Endocrine Society, concludes that hormone therapy is still an acceptable treatment for menopausal symptoms. This statement has been endorsed by 12 other leading organizations in women’s health.
Major points of agreement among the societies include:
- Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms. Individualization is key in the decision to use hormone therapy.
- If women have only vaginal dryness or discomfort with intercourse, the preferred treatments are low doses of vaginal estrogen.
- Women who still have a uterus need to take a progestogen (progesterone or a similar product) along with the estrogen to prevent cancer of the uterus. Women who have had their uterus removed can take estrogen alone.
- Both estrogen therapy and estrogen with progestogen therapy increase the risk of blood clots in the legs and lungs, similar to birth control pills, patches, and rings. Although the risks of blood clots and stroke increase with either type of hormone therapy, the risk is rare in women ages 50-59.
- An increased risk in breast cancer is seen with 5 or more years of continuous estrogen with progestogen therapy, possibly earlier. The risk decreases after hormone therapy is stopped.”