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Climacteric medicine: European Menopause and Andropause Society (EMAS) statements on postmenopausal hormonal therapy

Skouby, Sven O; Barlow, David; Samsioe, Göran LU ; Gompel, Anne; Pines, Amos; Al-Azzawi, Farok; Graziottin, Allezzandra; Hudita, Decebal and Rozenberg, Serge (2004) In Maturitas 48(1). p.19-25
Abstract
Hormonal therapy (HT) is one of the most frequently prescribed drug regimens for women after the age of 50 years. HT has been developed progressively since the 1960s to provide estrogen to those women (a) who require relief of symptoms which have resulted from reduced circulating estrogen or (b) to act as an anti-resorptive agent to counteract the effect of the increased bone turnover which occurs with falling menopausal estrogen levels and which results in loss of bone mass leading to postmenopausal osteoporosis. However, a large number of women pass through the menopausal transition without experiencing distress as a result of the natural fall in estrogen hormone levels and since the introduction HT has been thought to be associated with... (More)
Hormonal therapy (HT) is one of the most frequently prescribed drug regimens for women after the age of 50 years. HT has been developed progressively since the 1960s to provide estrogen to those women (a) who require relief of symptoms which have resulted from reduced circulating estrogen or (b) to act as an anti-resorptive agent to counteract the effect of the increased bone turnover which occurs with falling menopausal estrogen levels and which results in loss of bone mass leading to postmenopausal osteoporosis. However, a large number of women pass through the menopausal transition without experiencing distress as a result of the natural fall in estrogen hormone levels and since the introduction HT has been thought to be associated with a number of health benefits that have been tested in clinical trials but not substantiated. In women experiencing distressing climacteric symptoms double-blind randomised controlled clinical trials with a variety of HT regimens have shown that HT of any type provides symptom relief with no alternative treatment of similar effect. The dose and regimen of HT need to be individualised and in general the appropriate dose is dependent on the menopausal age. Women experiencing urogenital estrogen deficiency symptoms require long-term treatment which is most easily achieved with local estrogen. With the perspective provided by the most recent epidemiological findings not least from the estrogen only arm of the Women's Health Initiative Study (WHI) EMAS supports research activities generating HT with new compositions including lower doses and a wider range of progestins in order to positively affect the balance of clinical benefit and risk. Currently, however, individualized and appropriate prescription of the available HT products together with life-style management will sustain possibilities for beneficial effects on climacteric symptoms, quality of life and degenerative diseases after the menopause. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Postmenopausal hormonal therapy, EMAS, Climacteric medicine, Position paper
in
Maturitas
volume
48
issue
1
pages
19 - 25
publisher
Elsevier
external identifiers
  • pmid:15223104
  • scopus:3042591080
ISSN
1873-4111
DOI
10.1016/j.maturitas.2004.03.003
language
English
LU publication?
yes
id
ec49195a-42fe-4392-8775-49af9ba8f6d0 (old id 1130931)
date added to LUP
2008-06-18 12:27:49
date last changed
2017-10-22 03:47:57
@article{ec49195a-42fe-4392-8775-49af9ba8f6d0,
  abstract     = {Hormonal therapy (HT) is one of the most frequently prescribed drug regimens for women after the age of 50 years. HT has been developed progressively since the 1960s to provide estrogen to those women (a) who require relief of symptoms which have resulted from reduced circulating estrogen or (b) to act as an anti-resorptive agent to counteract the effect of the increased bone turnover which occurs with falling menopausal estrogen levels and which results in loss of bone mass leading to postmenopausal osteoporosis. However, a large number of women pass through the menopausal transition without experiencing distress as a result of the natural fall in estrogen hormone levels and since the introduction HT has been thought to be associated with a number of health benefits that have been tested in clinical trials but not substantiated. In women experiencing distressing climacteric symptoms double-blind randomised controlled clinical trials with a variety of HT regimens have shown that HT of any type provides symptom relief with no alternative treatment of similar effect. The dose and regimen of HT need to be individualised and in general the appropriate dose is dependent on the menopausal age. Women experiencing urogenital estrogen deficiency symptoms require long-term treatment which is most easily achieved with local estrogen. With the perspective provided by the most recent epidemiological findings not least from the estrogen only arm of the Women's Health Initiative Study (WHI) EMAS supports research activities generating HT with new compositions including lower doses and a wider range of progestins in order to positively affect the balance of clinical benefit and risk. Currently, however, individualized and appropriate prescription of the available HT products together with life-style management will sustain possibilities for beneficial effects on climacteric symptoms, quality of life and degenerative diseases after the menopause.},
  author       = {Skouby, Sven O and Barlow, David and Samsioe, Göran and Gompel, Anne and Pines, Amos and Al-Azzawi, Farok and Graziottin, Allezzandra and Hudita, Decebal and Rozenberg, Serge},
  issn         = {1873-4111},
  keyword      = {Postmenopausal hormonal therapy,EMAS,Climacteric medicine,Position paper},
  language     = {eng},
  number       = {1},
  pages        = {19--25},
  publisher    = {Elsevier},
  series       = {Maturitas},
  title        = {Climacteric medicine: European Menopause and Andropause Society (EMAS) statements on postmenopausal hormonal therapy},
  url          = {http://dx.doi.org/10.1016/j.maturitas.2004.03.003},
  volume       = {48},
  year         = {2004},
}