Breaking down barriers for prescribing and using hormone therapy for the treatment of menopausal symptoms: an experts’ perspective

Rozenberg, Serge; Panay, Nick; Gambacciani, Marco; Cano, Antonio; Gray, Sarah; Schaudig, Katrin

doi:10.1080/17512433.2023.2219056

Cited by 8 publications

(4 citation statements)

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“…Often, the ultimate strategy is determined by a personal decision. 12 In light of this, it is strategic for women's health to evaluate potential variations in the management of peri-and postmenopausal women regarding different risks and the use of HRT, depending on the specialist involved (cardiologist, endocrinologist, gynecologist).…”

Section: Introductionmentioning

confidence: 99%

Sharing the multidisciplinary clinical approach to peri‐ and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice

Colacurci,

Filardi,

Chiantera

et al. 2024

Intl J Gynecology & Obste

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ObjectiveThe critical phase of perimenopausal period is marked by a reduction in estrogen levels, leading to various clinical issues (vasomotor and neurodegenerative symptoms, increased osteoporosis risk and cardiovascular risk). These complex clinical scenarios pose challenges to clinicians in providing the right support for diagnosis and treatment. A group of Italian cardiologists, endocrinologists, and gynecologists conducted a survey among expert colleagues to assess consensus on controversial issues and best practices for screening and treating peri‐ and postmenopausal women.MethodsThe Delphi methodology was used to analyze responses from a qualitative expert panel comprising 25 cardiologists, 25 endocrinologists, and 25 gynecologists, selected nationwide. Two consecutive questionnaires were proposed between February and May 2023. Agreement among experts was assessed following the Delphi method as developed by the RAND Corporation.ResultsThe results of this Delphi Consensus have been shared by the leading scientific societies: Italian Society of Cardiology, Italian Society of Endocrinology, Italian Society of Gynecology and Obstetrics, and Italian Hospital Obstetricians Gynecologists Association.ConclusionsThe experts highlighted comorbidities and hormone deprivation as crucial clinical problems to be evaluated in perimenopausal women, requiring investigation from cardiovascular and endocrinologic perspectives to assess cardiovascular risk, involving the use of BMI, standard blood samples, endocrine‐metabolic tests, and lifestyle assessment, particularly in women with higher cardiovascular and metabolic risks candidates for hormone replacement therapy (HRT). The experts also agreed on the benefits of HRT in improving lipid metabolism and reducing insulin resistance, thereby mitigating the metabolic risks associated with menopause. However, this therapy should be tailored considering individual women's comorbidities and thrombotic risk.

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Section: Introductionmentioning

confidence: 99%

Sharing the multidisciplinary clinical approach to peri‐ and postmenopausal women: A Delphi consensus among Italian gynecologists, endocrinologists, and cardiologists for an integrated and optimal approach to clinical practice

Colacurci,

Filardi,

Chiantera

et al. 2024

Intl J Gynecology & Obste

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“…Regarding the RR of cancer, the values over 1:50 are considered relevant for any event. At this point, hormone therapy would have no relevant impact on the onset of breast cancer compared to familial or genetic risk 8 . However, the fear is still very great in the perception of women in relation to breast cancer.…”

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confidence: 99%

“…However, the fear is still very great in the perception of women in relation to breast cancer. Non-hormonal therapy could be an alternative, but side effects and lack of improvement are the main reasons for non-adherence to patients 8 . Therefore, estrogen therapy is still more effective for this treatment.…”

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confidence: 99%

“…It is a great concern to alleviate these symptoms, which affect sleep patterns, professional activities, and quality of life 1 , 2 . The hormone therapy with estrogen is a controversial question: it decreases the symptoms, but may impact the prognosis of the patient 1 - 3 , 8 . The HABITS trial showed 2.4 times more risk of new breast cancer events in breast cancer survivors with a cumulative incidence of 22.2% in the group taking hormone replacement versus 8% in the control arm at 5 years 10 .…”

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confidence: 99%

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