Hormone Therapy and Other Treatments for Symptoms of Menopause

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#acupuncture-therapy #administration-intravaginal #amines #antidepressive-agents #atrophy

Hormone Therapy and Other Treatments for Symptoms of Menopause

Hill et al., 2016 | Am Fam Physician | Systematic Review

Citation

Hill D Ashley, Crider Mark, Hill Susan R. Hormone Therapy and Other Treatments for Symptoms of Menopause. Am Fam Physician. 2016-Dec-01;94(11):884-889

Abstract

The results of large clinical trials have led physicians and patients to question the safety of hormone therapy for menopause. In the past, physicians prescribed hormone therapy to improve overall health and prevent cardiac disease, as well as for symptoms of menopause. Combined estrogen/progestogen therapy, but not estrogen alone, increases the risk of breast cancer when used for more than three to five years. Therefore, in women with a uterus, it is recommended that physicians prescribe combination therapy only to treat menopausal symptoms such as vasomotor symptoms (hot flashes) and vaginal atrophy, using the smallest effective dosage for the shortest possible duration. Although estrogen is the most effective treatment for hot flashes, nonhormonal alternatives such as low-dose paroxetine, venlafaxine, and gabapentin are effective alternatives. Women with a uterus who are using estrogen should also take a progestogen to reduce the risk of endometrial cancer. Women who cannot tolerate adverse effects of progestogens may benefit from a combined formulation of estrogen and the selective estrogen receptor modulator bazedoxifene. There is no highquality, consistent evidence that yoga, paced respiration, acupuncture, exercise, stress reduction, relaxation therapy, and alternative therapies such as black cohosh, botanical products, omega-3 fatty acid supplements, and dietary Chinese herbs benefit patients more than placebo. One systematic review suggests modest improvement in hot flashes and vaginal dryness with soy products, and small studies suggest that clinical hypnosis significantly reduces hot flashes. Patients with genitourinary syndrome of menopause may benefit from vaginal estrogen, nonhormonal vaginal moisturizers, or ospemifene (the only nonhormonal treatment approved by the U.S. Food and Drug Administration for dyspareunia due to menopausal atrophy). The decision to use hormone therapy depends on clinical presentation, a thorough evaluation of the risks and benefits, and an informed discussion with the patient.

Key Findings

The decision to use hormone therapy depends on clinical presentation, a thorough evaluation of the risks and benefits, and an informed discussion with the patient.

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population genitourinary syndrome of menopause
Sample Size See abstract
Age Range See abstract
Condition stress

MeSH Terms

  • Acupuncture Therapy
  • Administration, Intravaginal
  • Amines
  • Antidepressive Agents
  • Atrophy
  • Cyclohexanecarboxylic Acids
  • Dietary Supplements
  • Drug Therapy, Combination
  • Dyspareunia
  • Estrogen Replacement Therapy
  • Estrogens
  • Exercise Therapy
  • Female
  • Gabapentin
  • Hot Flashes
  • Humans
  • Hypnosis
  • Indoles
  • Menopause
  • Paroxetine
  • Progestins
  • Selective Estrogen Receptor Modulators
  • Tamoxifen
  • Vagina
  • Vaginal Diseases
  • Vasomotor System
  • Venlafaxine Hydrochloride
  • gamma-Aminobutyric Acid

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review
  • Vertical: black-cohosh

Provenance

  • PMID: 27929271
  • DOI: (not available)
  • PMCID: Not in PMC
  • Verified: 2026-04-09 via PubMed E-utilities API

Source extracted via PubMed E-utilities API on 2026-04-09