Guidelines for hormone treatment of women in the menopausal transition and beyond<i>Position Statement by the Executive Committee of the International Menopause Society</i>(Revised October 15, 2004)

Naftolin, Frederick; Schneider, H. P. G.; Sturdee, David W.; Birkhäuser, Martin; Brincat, M.; Gambacciani, Marco; Genazzani, Ar; Limpaphayom, K; O’Neill, Sheila; Palacios, Santiago; Pines, Amos; Siseles, Néstor; Tan, D.; Burger, H. G.

doi:10.1080/13697130400014615

Cited by 48 publications

(21 citation statements)

References 28 publications

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“…Their metabolic, endocrine and sexual action can therefore be very different from one progestogen to another. This is the major reason why some negative data emerging from RCT, such as WHI, using the specific progestogen Medroxyprogesterone Acetate (MPA) with a high mineralcorticoid affinity and therefore a negative vascular profile, should not be generalized to the whole class of progestogens [6,14,18]. The choice of progestogens (progesterone or synthetic progestins) should be tailored according to the patient's therapeutic needs (androgenic, antiandrogenic, neutral) and metabolic risk profile [6].…”

Section: Initiation Of Treatmentmentioning

confidence: 99%

“…[14]. In about 10% of patients, especially women with Premature Ovarian Failure (POF) or early iatrogenic menopause, a higher dose may be required [10][11][12]14,18]. b) Progestogens.…”

Section: Initiation Of Treatmentmentioning

confidence: 99%

“…The history should be directed, in particular, to potential indications and contraindications (see below). Menopausal symptoms, menstrual and sexual history, co-morbidity between urogenital and sexual disorders [4,23], personal and or family history of osteoporotic fracture, venous thromboembolism, breast cancer, cardiovascular disease and Alzheimer disease should be evaluated and reported in the medical record [12,14,18]. The clinical examination should include a complete breast and gynecological examination [12].…”

Section: Monitoring Treatmentmentioning

confidence: 99%

“…As a general principle, HT should be initiated when menopausal symptoms occur [10][11][12]14,18]. In the perimenopause, treatment will be tailored according to the type of symptoms.…”

Section: Initiation Of Treatmentmentioning

confidence: 99%

“…They have dramatically illustrated the uncertainty and the emotional vulnerability of the medical profession regarding the usefulness and even the safety of HT [5]. Authoritative position statements [10][11][12] and practical recommendations and guidelines [14,[18][19][20] aimed at helping clinicians in clarifying the contradictory evidence emerging from the previous observational data vs the most recent RCT, HERS I, HERS II and WHI, have been published. Their conclusions and the most relevant published data will be the base of the present chapter, aimed at helping the clinician in his/her daily practice with the increasing population of postmenopausal women.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Hormonal Therapy after Menopause

Graziottin¹,

Whipple²,

Dennerstein³

et al. 2006

Standard Practice in Sexual Medicine

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Section: Initiation Of Treatmentmentioning

confidence: 99%

“…[14]. In about 10% of patients, especially women with Premature Ovarian Failure (POF) or early iatrogenic menopause, a higher dose may be required [10][11][12]14,18]. b) Progestogens.…”

Section: Initiation Of Treatmentmentioning

confidence: 99%

Section: Monitoring Treatmentmentioning

confidence: 99%

“…As a general principle, HT should be initiated when menopausal symptoms occur [10][11][12]14,18]. In the perimenopause, treatment will be tailored according to the type of symptoms.…”

Section: Initiation Of Treatmentmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hormonal Therapy after Menopause

Graziottin¹,

Whipple²,

Dennerstein³

et al. 2006

Standard Practice in Sexual Medicine

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Hormonersatztherapie

Mueck¹

Therapiehandbuch Gynäkologie Und Geburtshilfe

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Rationale for low-dose systemic hormone replacement therapy and review of estradiol 0.5 mg/NETA 0.1 mg

Johansen

Qvigstad

2008

Adv Therapy

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The menopausal transition is associated with several symptoms, for which both non-pharmacological and pharmacological measures are available to provide relief. However, present knowledge indicates that the former is not highly effective, and that the latter, in terms of systemic oestrogen and progestogen-based hormone replacement therapy (HRT), although being effective (e.g. on vasomotor symptoms, bleeding control, bone mineral density, vaginal atrophy and quality of life), can be associated with some caveats. Amongst these are an increased risk for coronary heart disease, breast cancer, venous thromboembolism and stroke. In recent years, literature has indicated a dose dependency for HRT on some of the caveats, hence authorities (Food and Drug Administration, and the European Medicines Agency) and menopause societies (International Menopause Society and North American Menopause Society) now recommend that women deemed in need of HRT should receive the lowest possible dose without compromising the effect of symptom relief. Estradiol 0.5 mg/norethisterone acetate (NETA) 0.1 mg, despite being a lower dose than conventional hormones, is a compound, among a few other low-dose options, that can be used in such therapy. As a first-line oral option, it has demonstrated its effectiveness (which seems comparable to other compounds), with high tolerability and, apparently, no safety concerns, in a 6-month study. Further long-term clinical trials and observational studies are mandatory in order to capture any potential harm as well as to elucidate this compound's full potential. Following a thorough literature search using PubMed and MEDLINE from the earliest publication dates through to January 2008, including results from various types of clinical trials and statements on HRT, we review the rationale for these recommendations. We also review the effects and safety of a novel 'ultra-low-dose' oral continuous combined HRT tablet, estradiol 0.5 mg/NETA 0.1 mg.

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Guidelines for hormone treatment of women in the menopausal transition and beyondPosition Statement by the Executive Committee of the International Menopause Society(Revised October 15, 2004)

Cited by 48 publications

References 28 publications

Hormonal Therapy after Menopause

Hormonal Therapy after Menopause

Hormonersatztherapie

Rationale for low-dose systemic hormone replacement therapy and review of estradiol 0.5 mg/NETA 0.1 mg

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