menopause

AACE/ACE Menopause Treatment Guideline Updated

The American Association of Clinical Endocrinologists (AACE) and the American College of Endocrinology (ACE) recently updated their menopause clinical practice guideline. The updates address use of hormone therapy in symptomatic, postmenopausal women.

The Position Statement on Menopause-2017 is the first update to the AACE/ACE menopause clinical guideline since its publication in 2011.
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The updated guideline now includes the following recommendations:

  • Decision to treat symptomatic, postmenopausal women with menopausal hormone therapy should be based on risk factors for cardiovascular (CV) disease, age, and time from onset of menopause.
  • Use of transdermal preparations instead of oral estrogen ones may be less likely to produce thrombotic risk and possibly risk of stroke and coronary artery disease (CAD).
  • If progesterone use is necessary, micronized progesterone is considered the safer alternative.
  • Selective serotonin reuptake inhibitors and possibly other non-hormonal agents may provide significant symptom relief in symptomatic menopausal women who face significant risk from use of hormone replacement therapy.
  • AACE does not recommend use of bioidentical hormone therapy.
  • AACE fully supports the recommendations of the Comité de l’Évolution des Pratiques en Oncologie regarding the management of menopause in women with breast cancer.
  • Hormone therapy is not recommended for the prevention of diabetes.
  • In women with previously diagnosed diabetes, hormone therapy should be individualized according to age, metabolic risk factors and CV risk factors.

—Christina Vogt

Reference:

Cobin RH, Goodman NF. American association of clinical endocrinologists and American college of endocrinology position statement on menopause- 2017 update. Endocr Pract. 2017;23(7). doi:10.4158/EP171828.PS.