martes, 27 de abril de 2010

Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society

Estrogen and progestogen use in postmenopausal women: 2010 position statement of The North American Menopause Society

NAMS has submitted updated guidelines on estrogen and progestogen use in postmenopausal women.
open here to see the full-text:

Objective: To update for both clinicians and the lay public the evidence-based position statement published by The North American Menopause Society (NAMS) in July 2008 regarding its recommendations for menopausal hormone therapy (HT) for postmenopausal women, with consideration for the therapeutic benefit-risk ratio at
various times through menopause and beyond.

Methods: An Advisory Panel of clinicians and researchers expert in the field of women_s health was enlisted to review the July 2008 NAMS position statement, evaluate new evidence through an evidence-based analysis, and reach consensus on recommendations. The Panel_s recommendations were reviewed and approved by the NAMS
Board of Trustees as an official NAMS position statement. Also participating in the review process were other interested organizations who then endorsed the document.

Results: Current evidence supports a consensus regarding the role of HT in postmenopausal women, when potential therapeutic benefits and risks around the time of menopause are considered. This paper lists all these areas along with explanatory comments. Areas that vary from the 2008 position statement are noted. A suggested reading list of key references published since the last statement is also provided.

Conclusions: Recent data support the initiation of HT around the time of menopause to treat menopause-related symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal women; or both. The benefit-risk ratio for menopausal HT is favorable for women who initiate HT close to menopause but decreases in older women and with time since menopause in previously untreated women.

Key Words: Bioidentical hormones Y Breast cancer Y Cardiovascular disease Y Cognitive decline Y Coronary heart disease Y Dementia Y Depression Y Diabetes mellitus Y Endometrial cancer Y Estrogen Y Estrogen progestogen therapy Y Estrogen therapy Y Hormone replacement therapy Y Hormone therapy Y Menopause Y Mood Y NAMS Y
Osteoporosis Y Ovarian cancer Y Perimenopause Y Postmenopause Y Premature menopause Y Premature ovarian insufficiency Y Progestogen Y Sexual function Y Stroke Y Total mortality Y Urinary health Y Quality of life Y Vaginal atrophy Y Vaginal health Y Vasomotor symptoms Y Venous thromboembolism Y Women_s Health Initiative.

This NAMS position statement has been endorsed by:
1 HealthyWomen (formerly the National Women_s Health Resource Center),
2 Asociacio´n Mexicana para el Estudio del Climaterio (AMEC),
3 Society of Obstetricians and Gynaecologists of Canada (SOGC)
4 The Endocrine Society,
5 American Medical Women_s Association (AMWA),
6 National Association of Nurse Practitioners in Women_s Health (NPWH).

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