Treatment of Symptoms of the Menopause: An Endocrine Society Clinical Practice Guideline

被引:559
作者
Stuenkel, Cynthia A. [1 ]
Davis, Susan R. [2 ]
Gompel, Anne [3 ]
Lumsden, Mary Ann [4 ]
Murad, M. Hassan [5 ]
Pinkerton, Joann V. [6 ]
Santen, Richard J. [7 ]
机构
[1] Univ Calif San Diego, Endocrine Metab, La Jolla, CA 92093 USA
[2] Monash Univ, Sch Publ Hlth & Prevent Med, Melbourne, Vic 03004, Australia
[3] Univ Paris 05, Hop Univ Port Royal Cochin, Unit Gynecol Endocrnienne, F-75014 Paris, France
[4] Univ Glasgow, Sch Med, Glasgow G31 2ER, Lanark, Scotland
[5] Mayo Clin, Div Prevent Med, Rochester, MN 55905 USA
[6] Univ Virginia, Obstet & Gynecol, Charlottesville, VA 22908 USA
[7] Univ Virginia Hlth Syst, Charlottesville, VA 22903 USA
关键词
POSTMENOPAUSAL HORMONE-THERAPY; CONJUGATED EQUINE ESTROGENS; RANDOMIZED DOUBLE-BLIND; BREAST-CANCER RISK; BONE-MINERAL DENSITY; LOW-DOSE ESTRADIOL; COGNITIVE-BEHAVIOR THERAPY; CORONARY-HEART-DISEASE; CONTROLLED CROSSOVER TRIAL; VULVO-VAGINAL ATROPHY;
D O I
10.1210/jc.2015-2236
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
Objective: The objective of this document is to generate a practice guideline for the management and treatment of symptoms of the menopause. Participants: The Treatment of Symptoms of the Menopause Task Force included six experts, a methodologist, and a medical writer, all appointed by The Endocrine Society. Evidence: The Task Force developed this evidenced-based guideline using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe the strength of recommendations and the quality of evidence. The Task Force commissioned three systematic reviews of published data and considered several other existing meta-analyses and trials. Consensus Process: Multiple e-mail communications, conference calls, and one face-to-face meeting determined consensus. Committees of The Endocrine Society, representatives from endorsing societies, and members of The Endocrine Society reviewed and commented on the drafts of the guidelines. The Australasian Menopause Society, the British Menopause Society, European Menopause and Andropause Society, the European Society of Endocrinology, and the International Menopause Society (co-sponsors of the guideline) reviewed and commented on the draft. Conclusions: Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms and other symptoms of the climacteric. Benefits may exceed risks for the majority of symptomatic postmenopausal women who are under age 60 or under 10 years since the onset of menopause. Health care professionals should individualize therapy based on clinical factors and patient preference. They should screen women before initiating MHT for cardiovascular and breast cancer risk and recommend the most appropriate therapy depending on risk/benefit considerations. Current evidence does not justify the use of MHT to prevent coronary heart disease, breast cancer, or dementia. Other options are available for those with vasomotor symptoms who prefer not to use MHT or who have contraindications because these patients should not use MHT. Low-dose vaginal estrogen and ospemifene provide effective therapy for the genitourinary syndrome of menopause, and vaginal moisturizers and lubricants are available for those not choosing hormonal therapy. All postmenopausal women should embrace appropriate lifestyle measures.
引用
收藏
页码:3975 / 4011
页数:37
相关论文
共 366 条
[81]
Adverse events reported by postmenopausal women in controlled trials with raloxifene [J].
Davies, GC ;
Huster, WJ ;
Lu, YL ;
Plouffe, L ;
Lakshmanan, M .
OBSTETRICS AND GYNECOLOGY, 1999, 93 (04) :558-565
[82]
The effects of tibolone on mood and libido [J].
Davis, SR .
MENOPAUSE-THE JOURNAL OF THE NORTH AMERICAN MENOPAUSE SOCIETY, 2002, 9 (03) :162-170
[83]
Menopausal hormone therapy-ovarian cancer risk revisited [J].
Davis, Susan R. ;
Baber, Rodney .
NATURE REVIEWS ENDOCRINOLOGY, 2015, 11 (06) :322-323
[84]
Menopausal hormone therapy and new-onset diabetes in the French Etude Epidemiologique de Femmes de la Mutuelle G,n,rale de l'Education Nationale (E3N) cohort [J].
de Lauzon-Guillain, B. ;
Fournier, A. ;
Fabre, A. ;
Simon, N. ;
Mesrine, S. ;
Boutron-Ruault, M-C. ;
Balkau, B. ;
Clavel-Chapelon, F. .
DIABETOLOGIA, 2009, 52 (10) :2092-2100
[85]
Complications of pelvic organ prolapse surgery and methods of prevention [J].
de Tayrac, Renaud ;
Sentilhes, Loic .
INTERNATIONAL UROGYNECOLOGY JOURNAL, 2013, 24 (11) :1859-1872
[86]
Global Consensus Statement on menopausal hormone therapy [J].
de Villiers, T. J. ;
Gass, M. L. S. ;
Haines, C. J. ;
Hall, J. E. ;
Lobo, R. A. ;
Pierroz, D. D. ;
Rees, M. .
MATURITAS, 2013, 74 (04) :391-392
[87]
Safety and tolerability of bazedoxifene in postmenopausal women with osteoporosis: results of a 5-year, randomized, placebo-controlled phase 3 trial [J].
de Villiers, T. J. ;
Chines, A. A. ;
Palacios, S. ;
Lips, P. ;
Sawicki, A. Z. ;
Levine, A. B. ;
Codreanu, C. ;
Kelepouris, N. ;
Brown, J. P. .
OSTEOPOROSIS INTERNATIONAL, 2011, 22 (02) :567-576
[88]
Promestriene, a specific topic estrogen. Review of 40 years of vaginal atrophy treatment: is it safe even in cancer patients? [J].
Del Pup, Lino ;
Di Francia, Raffaele ;
Cavaliere, Carla ;
Facchini, Gaetano ;
Giorda, Giorgio ;
De Paoli, Paolo ;
Berretta, Massimiliano .
ANTI-CANCER DRUGS, 2013, 24 (10) :989-998
[89]
Open access publishing takes off - The dream is now achievable [J].
Delamothe, T ;
Smith, R .
BMJ-BRITISH MEDICAL JOURNAL, 2004, 328 (7430) :1-3
[90]
Effects of tibolone and raloxifene on bone mineral density in osteopenic postmenopausal women [J].
Delmas, P. D. ;
Davis, S. R. ;
Hensen, J. ;
Adami, S. ;
van Os, S. ;
Nijland, E. A. .
OSTEOPOROSIS INTERNATIONAL, 2008, 19 (08) :1153-1160