The 2017 hormone therapy position statement of the North American Menopause Society

Jo Ann V. Pinkerton, Fernando Sánchez Aguirre, Jennifer Blake, Felicia Cosman, Howard Hodis, Susan Hoffstetter, Andrew M. Kaunitz, Sheryl A. Kingsberg, Pauline M. Maki, Jo Ann E. Manson, Polly Marchbanks, Michael R. McClung, Lila E. Nachtigall, Lawrence M. Nelson, Diane Pace, Robert L. Reid, Phillip M. Sarrel, Jan L. Shifren, Cynthia A. Stuenkel, Wulf H. Utian

Research output: Contribution to journalReview article

178 Citations (Scopus)

Abstract

The 2017 Hormone Therapy Position Statement of The North American Menopause Society (NAMS) updates the 2012 Hormone Therapy Position Statement of The North American Menopause Society and identifies future research needs. An Advisory Panel of clinicians and researchers expert in the field of women's health and menopause was recruited by NAMS to review the 2012 Position Statement, evaluate new literature, assess the evidence, and reach consensus on recommendations, using the level of evidence to identify the strength of recommendations and the quality of the evidence. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees. Hormone therapy (HT) remains the most effective treatment for vasomotor symptoms (VMS) and the genitourinary syndrome of menopause (GSM) and has been shown to prevent bone loss and fracture. The risks of HT differ depending on type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. Treatment should be individualized to identify the most appropriate HT type, dose, formulation, route of administration, and duration of use, using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of the benefits and risks of continuing or discontinuing HT. For women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications, the benefit-risk ratio is most favorable for treatment of bothersome VMS and for those at elevated risk for bone loss or fracture. For women who initiate HT more than 10 or 20 years from menopause onset or are aged 60 years or older, the benefit-risk ratio appears less favorable because of the greater absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Longer durations of therapy should be for documented indications such as persistent VMS or bone loss, with shared decision making and periodic reevaluation. For bothersome GSM symptoms not relieved with over-the-counter therapies and without indications for use of systemic HT, low-dose vaginal estrogen therapy or other therapies are recommended.

Original languageEnglish (US)
Pages (from-to)728-753
Number of pages26
JournalMenopause
Volume24
Issue number7
DOIs
StatePublished - Jul 1 2017

Fingerprint

Hormones
Menopause
Therapeutics
Odds Ratio
Trustees
Bone and Bones
Bone Fractures
Venous Thromboembolism
Women's Health
Progestins
Coronary Disease
Dementia
Consensus
Decision Making
Estrogens
Stroke
Research Personnel

All Science Journal Classification (ASJC) codes

  • Obstetrics and Gynecology

Cite this

Pinkerton, J. A. V., Aguirre, F. S., Blake, J., Cosman, F., Hodis, H., Hoffstetter, S., ... Utian, W. H. (2017). The 2017 hormone therapy position statement of the North American Menopause Society. Menopause, 24(7), 728-753. https://doi.org/10.1097/GME.0000000000000921

The 2017 hormone therapy position statement of the North American Menopause Society. / Pinkerton, Jo Ann V.; Aguirre, Fernando Sánchez; Blake, Jennifer; Cosman, Felicia; Hodis, Howard; Hoffstetter, Susan; Kaunitz, Andrew M.; Kingsberg, Sheryl A.; Maki, Pauline M.; Manson, Jo Ann E.; Marchbanks, Polly; McClung, Michael R.; Nachtigall, Lila E.; Nelson, Lawrence M.; Pace, Diane; Reid, Robert L.; Sarrel, Phillip M.; Shifren, Jan L.; Stuenkel, Cynthia A.; Utian, Wulf H.

In: Menopause, Vol. 24, No. 7, 01.07.2017, p. 728-753.

Research output: Contribution to journalReview article

Pinkerton, JAV, Aguirre, FS, Blake, J, Cosman, F, Hodis, H, Hoffstetter, S, Kaunitz, AM, Kingsberg, SA, Maki, PM, Manson, JAE, Marchbanks, P, McClung, MR, Nachtigall, LE, Nelson, LM, Pace, D, Reid, RL, Sarrel, PM, Shifren, JL, Stuenkel, CA & Utian, WH 2017, 'The 2017 hormone therapy position statement of the North American Menopause Society', Menopause, vol. 24, no. 7, pp. 728-753. https://doi.org/10.1097/GME.0000000000000921
Pinkerton JAV, Aguirre FS, Blake J, Cosman F, Hodis H, Hoffstetter S et al. The 2017 hormone therapy position statement of the North American Menopause Society. Menopause. 2017 Jul 1;24(7):728-753. https://doi.org/10.1097/GME.0000000000000921
Pinkerton, Jo Ann V. ; Aguirre, Fernando Sánchez ; Blake, Jennifer ; Cosman, Felicia ; Hodis, Howard ; Hoffstetter, Susan ; Kaunitz, Andrew M. ; Kingsberg, Sheryl A. ; Maki, Pauline M. ; Manson, Jo Ann E. ; Marchbanks, Polly ; McClung, Michael R. ; Nachtigall, Lila E. ; Nelson, Lawrence M. ; Pace, Diane ; Reid, Robert L. ; Sarrel, Phillip M. ; Shifren, Jan L. ; Stuenkel, Cynthia A. ; Utian, Wulf H. / The 2017 hormone therapy position statement of the North American Menopause Society. In: Menopause. 2017 ; Vol. 24, No. 7. pp. 728-753.
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