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Menopausal Combined Hormone Therapy Update

Therapeutics Initiative (University of British Columbia)

Therapeutics Letter 46 provides an update on menopausal combined hormone therapy. Conclusions: Long-term combined hormone therapy leads to more harm than good in menopausal women whether they are healthy or have coronary artery disease. It is not a defensible preventive strategy. For severe vasomotor symptoms not controlled by other means, low dose estrogen (eg. 0.3 mg CEE for women without a uterus) or estrogen/progestin (eg. 0.3 mg CEE/ 1.25 mg MPA for women with a uterus) can be prescribed for symptomatic benefit, as shown by the Women’s Hope RCT. Symptomatic therapy should be limited to at most 1 – 2 years (see Therapeutics Letter 14) Women prescribed combined hormone therapy should be alerted to the increased risk of venous thromboembolic disease, stroke and breast cancer, and reminded periodically if longer-term therapy is contemplated. Until other hormonal therapies (including estrogen alone) or raloxifene have been demonstrated to provide more good than harm in long-term RCTs, they cannot be recommended for preventive therapy without ignoring the lessons from these two landmark clinical trials.

Other

eng

2023-06-20

Attribution-NonCommercial-NoDerivatives 4.0 International

http://hdl.handle.net/2429/85035

Reviewed

http://creativecommons.org/licenses/by-nc-nd/4.0/