NEW YORK (Reuters Health) - Hormone therapy should still be offered and can benefit younger women going through menopause, members of the International Menopause Society (IMS) conclude in updated treatment recommendations.
"The safety of hormone therapy largely depends on age," Dr. Amos Pines of Ichilov Hospital in Tel Aviv, Israel and colleagues from the IMS write in a consensus statement published in the journal Climacteric. "Women younger than 60 years old should not be concerned about the safety profile of hormone therapy."
Nevertheless, they add, hormones should be given in the lowest possible dose and should only be given if needed to resolve symptoms. Women taking hormone therapy should also see their doctor at least once a year.
The use of hormone therapy changed radically since 2002, after the results of the Women's Health Initiative study were released. The study found that hormones didn't protect against heart disease and that the risks outweighed their benefits, Pines and his team note.
However, the fact that the study included women who were 63 when the trial began "was not given enough importance at the time." The risk-benefit ratio for younger women is different, they add.
Hormone therapy remains the best way to treat genital problems related to estrogen deficiency in menopausal women, the researchers note, and can also improve sleep and restore libido.
Hormone therapy is also effective for treating osteoporosis, especially in women younger than 60 and those with premature menopause, Pines and his colleagues add. Hormones are also likely to be beneficial for women under 60 who have recently undergone menopause and have no cardiovascular disease.
But the risks and benefits should be weighed when considering continued use of hormone therapy to protect the heart or guard against bone loss in women older than 60, the researchers add.
Risks of hormone therapy can include endometrial cancer if estrogen is not given with progesterone, as well as blood clots and cardiovascular events, especially after 60, they point out. Giving estrogen through the skin, via patches or similar approaches, may reduce the risk that comes with oral hormone therapy, the researchers suggest, and lower dosages of hormones may also be safer.
The IMS statement also emphasizes the importance of a healthy lifestyle in maintaining health after menopause.
"New data and reanalyzes of older studies by women's 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," the IMS concludes.
