IMS updated recommendations on postmenopausal hormo...( inimal until age 60) and is also posit...)

inimal until age 60), and is also positively associated with obesity and thrombophilia. By avoiding first-pass hepatic metabolism, transdermal estrogen may avert the risk associated with oral HT. The impact on the risk of a thromboembolic event may also be affected by progestogen, depending on the type. Late starters of standard-dose HT may have a transient slightly increased risk for coronary events. The risk of stroke is correlated with age. HT may increase the risk of stroke after the age of 60.

Safety data from studies of low-dose and ultra-low-dose regimens of estrogen and progestogen are encouraging.

ALTERNATIVE TREATMENTS

The efficacy and safety of complementary alternative medicines have not been demonstrated and further studies are required.

Selective serotonin reuptake inhibitors, selective noradrenaline reuptake inhibitors and gabapentin are effective in reducing vasomotor symptoms in short-term studies. Their long-term safety needs further evaluation.

There are no medical or scientific reasons to recommend unregistered bioidentical hormones. The measurement of hormone levels in the saliva is not clinically useful. These customized hormonal preparations have not been tested in studies and their purity and risks are unknown.

RESEARCH

There is urgent need for further research especially into the relative merits of lower doses, regimens and routes of administration.

CONCLUSION

The safety of HT largely depends on age. Women younger than 60 years old should not be concerned about the safety profile of HT. New data and re-analyses of older studies by womens age show that, for most women, the potential benefits of hormone therapy given for a clear indication are many and the risks are few when initiated within a few years of menopause. In view of the new data, Regulatory Authorities should review their current recommendations as a priority.

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Contact: Jean Wright
jwright.ims@btopenworld.com
International Menopause Society
16-May-2007


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