The 2012 Hormone Therapy Position Statement Of: The North American Menopause Society

Overview

Journal Menopause

Specialty Gynecology & Obstetrics

Date 2012 Feb 28

PMID 22367731

Citations 153

Affiliations

Soon will be listed here.

Abstract

Objective: This position statement aimed to update the evidence-based position statement published by The North American Menopause Society (NAMS) in 2010 regarding recommendations for hormone therapy (HT) for postmenopausal women. This updated position statement further distinguishes the emerging differences in the therapeutic benefit-risk ratio between estrogen therapy (ET) and combined estrogen-progestogen therapy (EPT) at various ages and time intervals since menopause onset.

Methods: An Advisory Panel of expert clinicians and researchers in the field of women's health was enlisted to review the 2010 NAMS position statement, evaluate new evidence, and reach consensus on recommendations. The Panel's recommendations were reviewed and approved by the NAMS Board of Trustees as an official NAMS position statement.

Results: Current evidence supports the use of HT for perimenopausal and postmenopausal women when the balance of potential benefits and risks is favorable for the individual woman. This position statement reviews the effects of ET and EPT on many aspects of women's health and recognizes the greater safety profile associated with ET.

Conclusions: Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms and to prevent osteoporosis in women at high risk of fracture. The more favorable benefit-risk ratio for ET allows more flexibility in extending the duration of use compared with EPT, where the earlier appearance of increased breast cancer risk precludes a recommendation for use beyond 3 to 5 years.

Citing Articles

Fezolinetant's efficacy and safety in treatment of vasomotor symptoms in postmenopausal women: a meta-analysis and GRADE evaluation of randomized controlled trials.

Allam A, Alhateem M, Mahmoud A Eur J Med Res. 2025; 30(1):52.

PMID: 39849636 PMC: 11755967. DOI: 10.1186/s40001-025-02279-y.

User Outcomes for an App-Delivered Hypnosis Intervention for Menopausal Hot Flashes: Retrospective Analysis.

Scheffrahn K, Hall C, Muniz V, Elkins G JMIR Form Res. 2025; 9:e63948.

PMID: 39787588 PMC: 11757980. DOI: 10.2196/63948.

The combined predictive power of the atherogenic index of plasma and serum glycated albumin for cardiovascular events in postmenopausal patients with acute coronary syndrome after percutaneous coronary intervention.

Feng X, Liu Y, Yang J, Yang S, Zhou Z, Zhou Y Lipids Health Dis. 2024; 23(1):352.

PMID: 39478539 PMC: 11523790. DOI: 10.1186/s12944-024-02335-2.

Evaluation of the Potential Beneficial Effects of L. Extract Supplementation in Postmenopausal Discomfort.

Macri R, Maiuolo J, Scarano F, Musolino V, Fregola A, Gliozzi M Nutrients. 2024; 16(16).

PMID: 39203788 PMC: 11357168. DOI: 10.3390/nu16162651.

Breast cancer survivals and hormone therapy: estrogen and melatonin.

Soares Junior J, Mota B, Nobrega G, Filassi J, Sorpreso I, Baracat E Rev Assoc Med Bras (1992). 2023; 69(10):e6910EDI.

PMID: 37792874 PMC: 10547489. DOI: 10.1590/1806-9282.6910EDI.

References

Heiss G, Wallace R, Anderson G, Aragaki A, Beresford S, Brzyski R . Health risks and benefits 3 years after stopping randomized treatment with estrogen and progestin. JAMA. 2008; 299(9):1036-45. DOI: 10.1001/jama.299.9.1036. View

Haimov-Kochman R, Barak-Glantz E, Arbel R, Leefsma M, Brzezinski A, Milwidsky A . Gradual discontinuation of hormone therapy does not prevent the reappearance of climacteric symptoms: a randomized prospective study. Menopause. 2006; 13(3):370-6. DOI: 10.1097/01.gme.0000186663.36211.c0. View

Johnson S, Ettinger B, Macer J, Ensrud K, Quan J, Grady D . Uterine and vaginal effects of unopposed ultralow-dose transdermal estradiol. Obstet Gynecol. 2005; 105(4):779-87. DOI: 10.1097/01.AOG.0000157116.23249.52. View

Sherwin B . Estrogen and/or androgen replacement therapy and cognitive functioning in surgically menopausal women. Psychoneuroendocrinology. 1988; 13(4):345-57. DOI: 10.1016/0306-4530(88)90060-1. View

Schisterman E, Gallagher A, Merz C, Whitcomb B, Faraggi D, Moysich K . The association of hormone replacement therapy and coronary calcium as determined by electron beam tomography. J Womens Health Gend Based Med. 2002; 11(7):631-8. DOI: 10.1089/152460902760360577. View

Schwartz A, Wenzlaff A, Prysak G, Murphy V, Cote M, Brooks S . Reproductive factors, hormone use, estrogen receptor expression and risk of non small-cell lung cancer in women. J Clin Oncol. 2007; 25(36):5785-92. DOI: 10.1200/JCO.2007.13.3975. View

Salpeter S, Walsh J, Greyber E, Salpeter E . Brief report: Coronary heart disease events associated with hormone therapy in younger and older women. A meta-analysis. J Gen Intern Med. 2006; 21(4):363-6. PMC: 1484709. DOI: 10.1111/j.1525-1497.2006.00389.x. View

Barnabei V, Cochrane B, Aragaki A, Nygaard I, Williams R, McGovern P . Menopausal symptoms and treatment-related effects of estrogen and progestin in the Women's Health Initiative. Obstet Gynecol. 2005; 105(5 Pt 1):1063-73. DOI: 10.1097/01.AOG.0000158120.47542.18. View

Grodstein F, Manson J, Stampfer M, Rexrode K . Postmenopausal hormone therapy and stroke: role of time since menopause and age at initiation of hormone therapy. Arch Intern Med. 2008; 168(8):861-6. PMC: 4001717. DOI: 10.1001/archinte.168.8.861. View

10.

Greendale G, Wight R, Huang M, Avis N, Gold E, Joffe H . Menopause-associated symptoms and cognitive performance: results from the study of women's health across the nation. Am J Epidemiol. 2010; 171(11):1214-24. PMC: 2915492. DOI: 10.1093/aje/kwq067. View

11.

Kanaya A, Herrington D, Vittinghoff E, Lin F, Grady D, Bittner V . Glycemic effects of postmenopausal hormone therapy: the Heart and Estrogen/progestin Replacement Study. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 2003; 138(1):1-9. DOI: 10.7326/0003-4819-138-1-200301070-00005. View

12.

Hoibraaten E, Qvigstad E, Arnesen H, Larsen S, Wickstrom E, Sandset P . Increased risk of recurrent venous thromboembolism during hormone replacement therapy--results of the randomized, double-blind, placebo-controlled estrogen in venous thromboembolism trial (EVTET). Thromb Haemost. 2001; 84(6):961-7. View

13.

SCHIFF I, Tulchinsky D, Cramer D, Ryan K . Oral medroxyprogesterone in the treatment of postmenopausal symptoms. JAMA. 1980; 244(13):1443-5. View

14.

Michael Y, Gold R, Manson J, Keast E, Cochrane B, Woods N . Hormone therapy and physical function change among older women in the Women's Health Initiative: a randomized controlled trial. Menopause. 2009; 17(2):295-302. PMC: 3106270. DOI: 10.1097/gme.0b013e3181ba56c7. View

15.

Pachman D, Jones J, Loprinzi C . Management of menopause-associated vasomotor symptoms: Current treatment options, challenges and future directions. Int J Womens Health. 2010; 2:123-35. PMC: 2971731. DOI: 10.2147/ijwh.s7721. View

16.

Elliott A, Hannaford P . Use of exogenous hormones by women and lung cancer: evidence from the Royal College of General Practitioners' Oral Contraception Study. Contraception. 2006; 73(4):331-5. DOI: 10.1016/j.contraception.2005.10.003. View

17.

Marttunen M, Hietanen P, Pyrhonen S, Tiitinen A, Ylikorkala O . A prospective study on women with a history of breast cancer and with or without estrogen replacement therapy. Maturitas. 2001; 39(3):217-25. DOI: 10.1016/s0378-5122(01)00211-0. View

18.

Greendale G, Huang M, Wight R, Seeman T, Luetters C, Avis N . Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology. 2009; 72(21):1850-7. PMC: 2690984. DOI: 10.1212/WNL.0b013e3181a71193. View

19.

Arana A, Varas C, Gonzalez-Perez A, Gutierrez L, Bjerrum L, Garcia Rodriguez L . Hormone therapy and cerebrovascular events: a population-based nested case-control study. Menopause. 2006; 13(5):730-6. DOI: 10.1097/01.gme.0000233494.28335.71. View

20.

Taioli E, Wynder E . Re: Endocrine factors and adenocarcinoma of the lung in women. J Natl Cancer Inst. 1994; 86(11):869-70. DOI: 10.1093/jnci/86.11.869. View