Breaking down barriers for prescribing and using hormone therapy for the treatment of menopausal symptoms: an experts’ perspective

Rozenberg, Serge; Panay, Nick; Gambacciani, Marco; Cano, Antonio; Gray, Sarah; Schaudig, Katrin

doi:10.1080/17512433.2023.2219056

Cited by 6 publications

(4 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Often, the ultimate strategy is determined by a personal decision. 12 In light of this, it is strategic for women's health to evaluate potential variations in the management of peri-and postmenopausal women regarding different risks and the use of HRT, depending on the specialist involved (cardiologist, endocrinologist, gynecologist).…”

Section: Introductionmentioning

confidence: 99%

Sharing the multidisciplinary clinical approach to peri‐ and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice

Colacurci,

Filardi,

Chiantera

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

ObjectiveThe critical phase of perimenopausal period is marked by a reduction in estrogen levels, leading to various clinical issues (vasomotor and neurodegenerative symptoms, increased osteoporosis risk and cardiovascular risk). These complex clinical scenarios pose challenges to clinicians in providing the right support for diagnosis and treatment. A group of Italian cardiologists, endocrinologists, and gynecologists conducted a survey among expert colleagues to assess consensus on controversial issues and best practices for screening and treating peri‐ and postmenopausal women.MethodsThe Delphi methodology was used to analyze responses from a qualitative expert panel comprising 25 cardiologists, 25 endocrinologists, and 25 gynecologists, selected nationwide. Two consecutive questionnaires were proposed between February and May 2023. Agreement among experts was assessed following the Delphi method as developed by the RAND Corporation.ResultsThe results of this Delphi Consensus have been shared by the leading scientific societies: Italian Society of Cardiology, Italian Society of Endocrinology, Italian Society of Gynecology and Obstetrics, and Italian Hospital Obstetricians Gynecologists Association.ConclusionsThe experts highlighted comorbidities and hormone deprivation as crucial clinical problems to be evaluated in perimenopausal women, requiring investigation from cardiovascular and endocrinologic perspectives to assess cardiovascular risk, involving the use of BMI, standard blood samples, endocrine‐metabolic tests, and lifestyle assessment, particularly in women with higher cardiovascular and metabolic risks candidates for hormone replacement therapy (HRT). The experts also agreed on the benefits of HRT in improving lipid metabolism and reducing insulin resistance, thereby mitigating the metabolic risks associated with menopause. However, this therapy should be tailored considering individual women's comorbidities and thrombotic risk.

show abstract

Section: Introductionmentioning

confidence: 99%

Sharing the multidisciplinary clinical approach to peri‐ and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice

Colacurci,

Filardi,

Chiantera

et al. 2024

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…Regarding the RR of cancer, the values over 1:50 are considered relevant for any event. At this point, hormone therapy would have no relevant impact on the onset of breast cancer compared to familial or genetic risk 8 . However, the fear is still very great in the perception of women in relation to breast cancer.…”

mentioning

confidence: 99%

“…However, the fear is still very great in the perception of women in relation to breast cancer. Non-hormonal therapy could be an alternative, but side effects and lack of improvement are the main reasons for non-adherence to patients 8 . Therefore, estrogen therapy is still more effective for this treatment.…”

mentioning

confidence: 99%

“…It is a great concern to alleviate these symptoms, which affect sleep patterns, professional activities, and quality of life 1 , 2 . The hormone therapy with estrogen is a controversial question: it decreases the symptoms, but may impact the prognosis of the patient 1 - 3 , 8 . The HABITS trial showed 2.4 times more risk of new breast cancer events in breast cancer survivors with a cumulative incidence of 22.2% in the group taking hormone replacement versus 8% in the control arm at 5 years 10 .…”

mentioning

confidence: 99%

See 1 more Smart Citation

Breast cancer survivals and hormone therapy: estrogen and melatonin

Soares Júnior,

Mota,

Nobrega

et al. 2023

Rev. Assoc. Med. Bras.

View full text Add to dashboard Cite

From couplepause to doublepause: the impact of midlife physical, psychological, and social changes on the sexual life of aging couples

Giraldi,

Nappi,

Palacios

et al. 2024

Sexual Medicine Reviews

View full text Add to dashboard Cite

Introduction Midlife men and women are facing frequent sexual problems that affect not only individuals’ sexual health but also the sexual health of aging couples. Objectives To review the main sexual life challenges faced by midlife couples, to present the concepts of couplepause and doublepause as 2 new paradigms to address the sexual health needs of aging couples, and to discuss key aspects in couple-focused care. Methods An online meeting attended by 5 European experts in sexual health was carried out in June 2023 to discuss the topic. The conversation centered on their clinical experience and expert opinion. Additionally, the indexed literature was reviewed to endorse and complement the expert opinions obtained in the aforementioned meeting. Results Midlife men and women face physical, psychological, and sociocultural changes that affect their sexual activity. These changes may be experienced differently between genders. Both members of a couple may experience age-related changes concurrently or in an unsynchronized manner affecting their sexual health. Communication, sharing expectations, defining sexual dynamics, and couple goals are determinant for the sexual health of a midlife couple. Couplepause and doublepause are 2 new complementary paradigms that effectively address the sexual health needs of aging couples as a unit, considering physical, psychological, cultural, social, and dyadic-related factors. Couple-centered strategies should promote open communication about couple intimacy issues, understanding the diverse expectations according to gender and orientation, communication styles, and goals. The following are identified as crucial aspects to promote couple-focused care: education and training of health care professionals, the provision of information to aging couples, physician involvement in addressing sexual problems, the need for collaboration across medical specialties, and the development of effective tools and strategies. Conclusions The sexual problems of aging couples should be managed following couple-centered strategies that effectively address their sexual health needs as a couple.

show abstract

Breaking down barriers for prescribing and using hormone therapy for the treatment of menopausal symptoms: an experts’ perspective

Cited by 6 publications

References 50 publications

Sharing the multidisciplinary clinical approach to peri‐ and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice

Sharing the multidisciplinary clinical approach to peri‐ and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice

Breast cancer survivals and hormone therapy: estrogen and melatonin

From couplepause to doublepause: the impact of midlife physical, psychological, and social changes on the sexual life of aging couples

Contact Info

Product

Resources

About