The American College of Obstetricians & Gynecologists (ACOG) has updated menopause treatment guidelines, highlighting the efficacy and safety of menopausal hormone therapy.
Following the 2002 Women’s Health Initiative (WHI) study, concerns about hormone therapy’s risks contributed to reduced use and lingering misconceptions.. While ACOG last updated its guidelines in 2014, the latest recommendation takes a closer look at the benefits of MHT for symptoms including hot flashes and sleep disruptions. The update also removes the recommendation to use the “lowest dose, shortest time” and the importance of timing,noting potential benefits and reduced risks when treatment begins before age 60 or within 10 years of menopause onset.
“Unfortunately, misconceptions about the risks of hormone therapy have affected some clinicians’ willingness to prescribe it and some patients’ interest in using it,” said Bruce Pier, MD, Co-Author of the guidelines. “This new guidance importantly includes a comprehensive review of the evidence on menopausal hormone therapy to guide individualized patient counseling and shared-decision-making conversations about treatment options.”
For women who cannot or prefer not to use hormones, ACOG also outlines nonhormonal options, including neurokinin receptor antagonists, SSRIs, and SNRIs.
The update also addresses the prevalence of common menopause symptoms, particularly sleep disruptions, hot flashes, and depressive feelings.
“Perimenopause and menopause symptoms can be debilitating, interfering with women’s overall health, their ability to care for their families, and their work and career,” said ACOG President Camille A. Clare, MD. “Ob-gyns are the leaders in menopause care, and as training and research continue to evolve, this guidance is important not only for them but also for our colleagues in other specialties who need to be aware of the evidence-based treatment options available. It is critically important that women have access to and coverage for evidence-based care, especially as menopause misinformation continues to flourish.”
