Overview

This talk will update participant knowledge about hormone therapy for menopause, focusing on our current understanding of the myths, benefits, and harms of treatment. The myth that hormone therapy is, in general, harmful, is based on data looking at the consequences of hormone therapy in individuals aged 60 and older. In contrast, the data on most individuals who are either under age 60 or less than 10 years from menopause show that the benefits appear to outweigh the risks. A clinical practice guideline published by the Endocrine Society recommends an individualized approach to treatment based on calculating baseline cardiovascular and breast cancer before initiating therapy. The benefits of hormone therapy for menopause include management of hot flashes and vaginal atrophy. It is not recommended for the prevention of cardiovascular disease, osteoporosis, or dementia. In the Women’s Health Initiative combined hormone therapy trial, risks included coronary events, stroke, venous thromboembolism, and breast cancer. No increase in either coronary heart disease or breast cancer risk was seen with unopposed estrogen. These results suggest that the progestin played an important role in the increased coronary and breast cancer risk seen with combined therapy. 

Learning Objectives

  • Learn when hormone therapy is indicated for menopause and how to prescribe it
  • Describe the origins of the myth that hormone therapy for menopause is, in general, harmful 
  • Identify data showing the benefits of hormone therapy for menopause in treating hot flashes and vaginal atrophy
  • Recognize the increase in risk for coronary events and breast cancer with combined estrogen-progestin treatment but not with estrogen alone
  • Recognize that the risk of coronary heart disease appears to depend on the timing of exposure, with no excess risk seen in younger (< 60 years old) individuals undergoing menopause 

Faculty Disclosures

Jane S. Sillman, MD

No financial relationships to disclose. 

Disclosures

Non-faculty contributors and others involved in the planning, development, and editing/review of the content have no relevant financial relationships to disclose.

CME/CE Information

AMA PRA Category 1 Credits

Accreditation Statement

pmiCME is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.


Designation Statement

pmiCME designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

For APRNs and PAs, AANPCB and NCCPA accept AMA PRA Category 1 Credit™ as the number of hours of participation (AANPCB) or as Category 1 CME credits (NCCPA).

Commercial Supporter

Not Applicable 

Education Partner

Not Applicable


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