The BMS 2016 recommendations on HRT.
All women should be able to access advice on how they can optimise their menopause transition
Individualised approach in assessing menopausal women: lifestyle advice, diet modification as well as discussion of the role of HRT.
Decision to use HRT should be made by each woman having been given sufficient information by her health professional to make a fully informed choice.
The HRT dosage, regimen and duration should be individualised,
with annual evaluation of advantages and disadvantages.
Transdermal administration of estradiol is unlikely to increase the risk of VTE or stroke and is associated with a lower risk compared with oral HRT.
The transdermal route should be considered first choice route, particularly in women with risk factors.
Micronised progesterone and dydrogesterone
may be associated with lower risk of breast cancer and a lower of VTE compared to other progestogens.
Arbitrary limits should not be placed on the duration of usage of HRT;
if symptoms persist, the benefits of hormone therapy
usually outweigh the risks.
HRT before the age of 60
has a favourable benefit/risk profile
and it is likely to be associated with
a reduction in coronary heart disease and cardiovascular mortality.
If HRT is to be used in women over 60 years of age,
lower doses should be started, preferably transdermal.
In women who initiated HRT more than 10 years after the menopause.
There is no increase in cardiovascular events,
cardiovascular mortality
or all-cause mortality
Women with POI should be encouraged to use HRT
at least until the average age of the menopause.
HRT and the COCP would both be suitable in POI.
HRT may result in a more favourable improvement in
bone density and cardiovascular markers.
All women should be able to access advice on how they can optimise their menopause transition
Individualised approach in assessing menopausal women: lifestyle advice, diet modification as well as discussion of the role of HRT.
Decision to use HRT should be made by each woman having been given sufficient information by her health professional to make a fully informed choice.
The HRT dosage, regimen and duration should be individualised,
with annual evaluation of advantages and disadvantages.
Transdermal administration of estradiol is unlikely to increase the risk of VTE or stroke and is associated with a lower risk compared with oral HRT.
The transdermal route should be considered first choice route, particularly in women with risk factors.
Micronised progesterone and dydrogesterone
may be associated with lower risk of breast cancer and a lower of VTE compared to other progestogens.
Arbitrary limits should not be placed on the duration of usage of HRT;
if symptoms persist, the benefits of hormone therapy
usually outweigh the risks.
HRT before the age of 60
has a favourable benefit/risk profile
and it is likely to be associated with
a reduction in coronary heart disease and cardiovascular mortality.
If HRT is to be used in women over 60 years of age,
lower doses should be started, preferably transdermal.
In women who initiated HRT more than 10 years after the menopause.
There is no increase in cardiovascular events,
cardiovascular mortality
or all-cause mortality
Women with POI should be encouraged to use HRT
at least until the average age of the menopause.
HRT and the COCP would both be suitable in POI.
HRT may result in a more favourable improvement in
bone density and cardiovascular markers.