The North American Menopause Society Offers Clarity on Hormone Therapy

By: Red Hot Mamas

Published: May 26, 2010

In an effort to shed new light on the often confusing and misinterpreted topic of hormone therapy (HT), last month, the North American Menopause Society (NAMS) issued an updated position statement on estrogen and progestogen use in postmenopausal women. Their position statement was endorsed by numerous associations, such as, the American Medical Women’s Association, The Endocrine Society, the National Association of Nurse Practitioners in Women’s Health, among others.

Modified to incorporate the most recent evidence regarding HT use for menopausal symptoms, the position statement also addresses the benefits and risks of HT. The treatment of moderate to severe vasomotor symptoms (hot flashes, night sweats) remains the primary indication for use of HT. It is also an effective treatment for vaginal atrophy and has been proven to reduce postmenopausal osteoporosis-related fractures. HT may also benefit some women with urge incontinence and it can improve health related quality of life through mood elevation and decreased menopausal symptoms. The full position statement also reported on HT & coronary heart disease, stroke, venous thrombo-embolism, diabetes, endometrial cancer, breast cancer, mood and depression, cognitive aging and dementia.

An Advisory Panel of women’s health clinicians and researchers were enlisted to review the NAMS position statement issued back in March 2007, to evaluate new study data and to reach a consensus on recommendations. The updated position statement focuses on the use of HT products available by prescription in the United States and Canada. The statement does not cover other hormones, such as estrogen agonists/antagonists (formerly called selective estrogen-receptor modulators), testosterone and over-the-counter treatment options.

In summary, NAMS concludes that the individualization of therapy remains essential when contemplating HT use. The benefit-risk ratio for an individual woman continually changes with her age and her menopause-related symptoms, any of which may negatively impact quality of life. Relevant risk factors include, disease risks, age at menopause, cause of menopause, prior use of any hormone and emerging medical conditions during treatment, among others.

The recommendation is for the lowest effective estrogen dose consistent with the individualized treatment goals. Recent data supports the initiation of HT around the time of menopause to treat menopause-related symptoms or treat/reduce the risk of certain disorders (like cardio-vascular diseases) in select postmenopausal women. At all times, HT use should be consistent with prescribed treatment goals, benefits and risks for each individual woman.

To read the entire NAMS position statement and details on the potential benefits and risks for specific menopause-related symptoms view their PDF.