Clearing up HRT confusion

The British Menopause Society (BMS) on May 23 released updated recommendations on hormone replacement therapy (HRT), claiming that they are finally providing clarity to this murky issue. The new guidelines appear in the society’s flagship journal, Menopause International. Developed by a panel of experts, the guidelines discuss how women can optimize their menopause transition, focusing in particular on lifestyle and diet and the pros and cons of complementary therapies.

The article discusses in depth the immediate and long-term effects of HRT; premature ovarian insufficiency (POI); routes and regimens for delivery of HRT; sexual function/androgens; and lifestyle modifications/alternatives to HRT. Some of the key points and recommendations in the article include:

--HRT prescribed before the age of 60 has a favorable benefit/risk profile.

-- If HRT is to be used in women older than 60, lower doses should be started, preferably with a transdermal route of administration.

--HRT is the first-line therapeutic intervention for the prevention and treatment of osteoporosis in women with POI and menopausal women younger than 60, particularly those with menopausal symptoms.

--Initiating HRT after the age of 60 for the sole purpose of the prevention of osteoporotic fractures is not recommended.

Extensive references and links to useful Web sites provide an opportunity to access extensive evidence-based information in each key area.

“Our aim is to provide helpful and pragmatic guidelines for health professionals involved in prescribing HRT and for women considering or currently using HRT,” stated Nick Panay, chair of the BMS and lead author of the recommendations, in a press release. “With these updated recommendations, it is hoped that HRT will once again be used appropriately and provide benefits for many women in their menopause.”