Guidelines Adopt an individualised approach at all stages of diagnosis, investigation and management of menopause.14

HRT is recommended as an effective
treatment for managing menopause symptoms14

In 2015, the National Institute for Health and Care Excellence (NICE) published the NG23 guideline, titled Menopause, diagnosis and management, which makes the following recommendations for the management of menopause:14

  • Adopt an individualised approach at all stages of diagnosis, investigation and management of menopause14
  • Offer women HRT for vasomotor symptoms after discussing with them the short-term (up to 5 years) and longer-term benefits and risks14
  • Consider HRT to alleviate low mood that arises as a result of the menopause14
  • Offer a choice of HRT preparations as follows:14
    • oestrogen and progestogen to women with a uterus
    • oestrogen alone to women without a uterus
NICE menopause guidance supports the use of transdermal
oestrogen preparations for vasomotor symptom control.14

Further guidelines &
recommendations on menopause

Primary Care Women’s Health Forum (PCWHF) guidelines17

There is robust evidence demonstrating that transdermal oestrogen in association with micronised progesterone could represent optimal HRT regimen17

International Menopause Society governing principles on HRT:18

  • HRT remains an effective therapy for vasomotor symptoms and urogenital atrophy compared to associated pharmacotherapies and non-pharmacotherapies*
  • Other menopause-related complaints, such as joint and muscle pains, mood swings, sleep disturbances and sexual dysfunction (including reduced libido) may improve during HRT
  • Quality of life and sexual function may also improve

*Androgen therapies, SERMS, complementary therapies, non-pharmacological and lifestyle interventions, SSRIs, SNRIs, antiepileptic drugs and other centrally acting drugs

References:

2. Panay N, Post Reprod Health 2014;20(2):69-72.
14. NICE Menopause: diagnosis and management. NICE guideline Published: 12 November 2015. Available from www.nice.org.uk/guidance/ng23 Last accessed: April 2021.
15. Oestrogel Summary of Product Characteristics. Available from https://www.medicines.org.uk/emc/product/353/smpc Last accessed: October 2021.
16. Data on file OES/2020/012.
17. PCWHF Easy HRT Prescribing Guide. Available from  https://pcwhf.co.uk/wp-content/uploads/2020/12/Prescribing-HRT-2.pdf Last accessed: April 2021.
18. Baber RJ, et al. Climacteric 2016;19(2):109-150.