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Climacteric medicine: European Menopause and Andropause Society (EMAS) 2004/2005 position statements on peri- and postmenopausal hormone replacement therapy

Skouby, Sven O; Al-Azzawi, Farook; Barlow, David; Calaf-Alsina Erdogan Ertungealp, Joaquin; Gompel, Anne; Graziottin, Alessandra; Hudita, Decebal; Pines, Amos; Rozenberg, Serge and Samsioe, Göran LU , et al. (2005) In Maturitas 51(1). p.8-14
Abstract
In women experiencing distressing climacteric symptoms during the peri- and postmenopause there is conclusive evidence from abundant randomised controlled trials that systemic hormone replacement therapy (HRT) of any type affords symptom relief, with no alternative treatment producing similar effect. Though this evidence is accumulating, the question of how to provide best clinical practice in an attempt to both alleviate the menopausal symptoms and prevent the more long-term postmenopausal degenerative diseases is still under debate. When providing climacteric medicine, the dose and regimen of HRT needs to be individualised based on the principle of choosing the lowest appropriate dose in relation to severity of symptoms and on the... (More)
In women experiencing distressing climacteric symptoms during the peri- and postmenopause there is conclusive evidence from abundant randomised controlled trials that systemic hormone replacement therapy (HRT) of any type affords symptom relief, with no alternative treatment producing similar effect. Though this evidence is accumulating, the question of how to provide best clinical practice in an attempt to both alleviate the menopausal symptoms and prevent the more long-term postmenopausal degenerative diseases is still under debate. When providing climacteric medicine, the dose and regimen of HRT needs to be individualised based on the principle of choosing the lowest appropriate dose in relation to severity of symptoms and on the menopausal age. However, few long-term data on different HRT formulations exist in symptomatic women, which also account for baseline risk of cardiovascular disease (CVD), breast cancer and osteoporosis. In most cases, an individualized prescription together with life-style management will sustain possibilities for net beneficial effects on climacteric symptoms, quality of life (QoL), sexuality and osteoporosis, with only rare risk of severe adverse effects. With the perspective provided by recent epidemiological findings, not least from the estrogen only arm of the Women's Health Initiative Study (WHI), European Menopause and Andropause Society (EMAS) supports research activities in symptomatic women with new HRT formulations in order to affect positively the balance of clinical benefit and risk, including specific information on QoL and also account for the traditional differences in treatment modalities between the US and Europe, and the difference in BMI, life-style and diet. In women experiencing an early menopause (<45 year) current data support a specific overall benefit of HRT. At present, more long-term systemic HRT may be considered in women at high risk of osteoporotic fractures, in particular when alternate therapies are either inappropriate or insufficiently effective, as benefits will outweigh any risks. In contrast, urogenital symptoms may be addressed efficiently and safely with long-term local estrogen therapy. (Less)
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Contribution to journal
publication status
published
subject
keywords
HRT, Postmenopause, Perimenopause, EMAS position statement, Climacteric medicine
in
Maturitas
volume
51
issue
1
pages
8 - 14
publisher
Elsevier
external identifiers
  • pmid:15883103
  • scopus:21044437661
ISSN
1873-4111
DOI
10.1016/j.maturitas.2005.02.019
language
English
LU publication?
no
id
f83e0200-e564-4132-a015-79ee86cab8df (old id 1134122)
date added to LUP
2008-06-18 12:08:43
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2017-07-23 03:44:35
@article{f83e0200-e564-4132-a015-79ee86cab8df,
  abstract     = {In women experiencing distressing climacteric symptoms during the peri- and postmenopause there is conclusive evidence from abundant randomised controlled trials that systemic hormone replacement therapy (HRT) of any type affords symptom relief, with no alternative treatment producing similar effect. Though this evidence is accumulating, the question of how to provide best clinical practice in an attempt to both alleviate the menopausal symptoms and prevent the more long-term postmenopausal degenerative diseases is still under debate. When providing climacteric medicine, the dose and regimen of HRT needs to be individualised based on the principle of choosing the lowest appropriate dose in relation to severity of symptoms and on the menopausal age. However, few long-term data on different HRT formulations exist in symptomatic women, which also account for baseline risk of cardiovascular disease (CVD), breast cancer and osteoporosis. In most cases, an individualized prescription together with life-style management will sustain possibilities for net beneficial effects on climacteric symptoms, quality of life (QoL), sexuality and osteoporosis, with only rare risk of severe adverse effects. With the perspective provided by recent epidemiological findings, not least from the estrogen only arm of the Women's Health Initiative Study (WHI), European Menopause and Andropause Society (EMAS) supports research activities in symptomatic women with new HRT formulations in order to affect positively the balance of clinical benefit and risk, including specific information on QoL and also account for the traditional differences in treatment modalities between the US and Europe, and the difference in BMI, life-style and diet. In women experiencing an early menopause (&lt;45 year) current data support a specific overall benefit of HRT. At present, more long-term systemic HRT may be considered in women at high risk of osteoporotic fractures, in particular when alternate therapies are either inappropriate or insufficiently effective, as benefits will outweigh any risks. In contrast, urogenital symptoms may be addressed efficiently and safely with long-term local estrogen therapy.},
  author       = {Skouby, Sven O and Al-Azzawi, Farook and Barlow, David and Calaf-Alsina Erdogan Ertungealp, Joaquin and Gompel, Anne and Graziottin, Alessandra and Hudita, Decebal and Pines, Amos and Rozenberg, Serge and Samsioe, Göran and Stevenson, John C},
  issn         = {1873-4111},
  keyword      = {HRT,Postmenopause,Perimenopause,EMAS position statement,Climacteric medicine},
  language     = {eng},
  number       = {1},
  pages        = {8--14},
  publisher    = {Elsevier},
  series       = {Maturitas},
  title        = {Climacteric medicine: European Menopause and Andropause Society (EMAS) 2004/2005 position statements on peri- and postmenopausal hormone replacement therapy},
  url          = {http://dx.doi.org/10.1016/j.maturitas.2005.02.019},
  volume       = {51},
  year         = {2005},
}