Providers treating symptoms of menopause in women should assess the individual benefits and risks of therapeutic options, according to guidelines issued by the Endocrine Society and published online October 7 in the Journal of Clinical Endocrinology and Metabolism. 

Authored by a task force chaired by Cynthia A. Stuenkel, MD, their recommendations for providers include the following: 

  • Women with a uterus who decide to undergo menopausal hormone therapy with estrogen and progestogen should be informed of the risks and benefits of that therapy, including the increased risk for breast cancer once treatment is discontinued. 
  • All women, including those receiving hormone therapy for menopause, should be advised to follow guidelines for breast cancer screening. 
  • Transdermal estrogen therapy by patch, gel, or spray is the recommended treatment; however, it does have an increased risk of venous thromboembolism. 
  • In women taking estrogen to relieve hot flashes, progestogen prevents uterine cancer; however, it is not necessary for women who have undergone a hysterectomy. 
  • Selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, gabapentin, or pregabalin are recommended for the management of moderate-to-severe hot flashes in women who prefer not to take or are contraindicated for hormone therapy.

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