Management of menopause

Abstract

SUMMARY During perimenopause and after menopause, women may experience diverse symptoms. All women require a comprehensive assessment of their current health and risks for future disease, appropriate screening, and promotion of a healthy lifestyle. Menopausal hormone therapy is the most effective treatment for menopausal symptoms. It can be offered to symptomatic patients with no contraindications following an individualised discussion about the risk of harms versus benefits. Menopausal hormone therapy is recommended for women with premature ovarian insufficiency (menopause occurring before 40 years of age) regardless of symptoms, unless contraindicated. Nonhormonal medications may improve symptoms for women who have contraindications to, or do not wish to take, menopausal hormone therapy.

Letter to the Editor: Evidence-based management of menopause

“…Magraith and Jang’s menopause review 1 contains unsupported claims. Menopausal hormone therapy (MHT) is characterised as ‘highly effective’ and ‘the most effective treatment’ for menopausal symptoms.…”

“…McGraith and Jang’s article on menopause makes statements and draws conclusions that are not supported by evidence. 1a Pharmaceutical companies have attempted to attribute all symptoms associated with ageing to menopause, 2a but the only symptoms proven to be associated with menopause are hot flushes and vaginal dryness. 3a The authors describe quality of life as an established benefit of MHT, but there is no evidence that MHT improves quality of life unless a woman is having severe hot flushes.…”