Origin, duration and interruption of hormone therapy for menopause
Summary of the conference presented at the Congress of the Latin American Federation of Climaterial and Menopausal Societies (FLASCYM) Mexico - June 2010
Abstract
In 2002, the WHI research (2002) (1) was published to study the risk-benefit balance for the prolonged use of hormonal therapy (TH) in menopause. Almost immediately in the United States (and then in the rest of the world) there were radical changes in the prescription of estrogen and progesterone-based therapies for menopause. Rarely did a single study impact so much and so quickly on the prescription with an abrupt fall. Subsequently, the reference institutions in the United States have recommended time and again, with uniform criteria, the TH "only for symptoms - the shortest time - the lowest dose", when these are moderate to severe (American College of Obstetricians and Gynecologists (2), North American Menopause Society and The Endocrine Society (3), European Menopause and Andropause Society -EMAS (4), etc.).
However, and surprisingly, eight years later, opinions and views on HT vary widely among specialists and general practitioners. As doctors have a strong influence on women's behavior towards menopause, users eventually receive unbalanced and incomplete information, with no strange negative contribution from the media and other sources. The first articles emphasized the benefits of TH and, in return, after WHI, emphasis was placed on risks. It has been assessed that the overall quality of information on menopause is poor and fraught with methodological defects, contradictions and conflicts of interest (5). Confusion reigns in users about the pros and cons of taking hormones for menopausal symptoms.
References
(2) American College of Obstetricians and Gynecologists, Women’s Health Care Physicians. ACOG practice bulletin. Clinical management guidelines for obstetrician-gynecologists. Obstet Gynecol 2004; 103(1): 203-16.
(3) North American Menopause Society. Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause 2010; 17(2): 242-55.
(4) Skouby SO, Al-Azzawi F, Barlow D, et al. Climacteric medicine: European Menopause and Andropause Society (EMAS) 2004/2005 position statements on peri- and postmenopausal hormone replacement therapy. Maturitas 2005; 51: 8-14.
(5) Pérez-López FR. An evaluation of the contents and quality of menopause information on the World Wide Web. Maturitas 2004; 49(4): 276-82.