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Are you confused about how HRT can be used for menopause?

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Just this month, two seemingly opposite statements about the value of hormone replacement therapy (HRT) for menopausal women came out of some prestigious and influential US bodies.

On one hand, an article was published by the Journal of the American Medical Association (JAMA) that deals with the finding of the the US Preventive Services Task Force (USPSTF) to evaluate “the benefits and harms of systemic (oral or transdermal) hormone therapy for the prevention of chronic conditions in postmenopausal women and whether outcomes vary by age or by timing of intervention after menopause.”

The patients being considered as candidates for this study were asymptomatic postmenopausal women who were considering hormone therapy for the primary prevention of chronic medical conditions. It did not include hormone therapy for the management of perimenopausal symptoms (during the years preceding a woman’s final menstrual period), or women who have had premature menopause (primary ovarian insufficiency) or have undergone surgical hysterectomy.

The USPSTF concluded with moderate certainty that the use of HRT (administering combined estrogen and progestin) for the primary prevention of chronic conditions in postmenopausal women with an intact uterus, and the use of estrogen alone in postmenopausal women who have had a hysterectomy, has no net benefit.

The recommendation of the USPSTF was against the use of HRT.

Dr. Stephanie Faubion, medical director of the North American Menopause Society (NAMS) took issue with the findings of the USPSTF study. 

One particular point she raised was that the USPSTF has not researched or made any statements about the use of HRT for the vasomotor symptoms of menopause (VMS). Vasomotor symptoms are usually described as night sweats, hot flashes, and flushes.

As outlined on the OBGYN network, “Vasomotor symptoms are the most commonly reported menopausal symptoms. These symptoms, often called hot flashes, are characterized by a sudden increase of blood flow, often to the face, neck, and chest, that causes the sensation of extreme heat and profuse sweating.”

When symptoms occur at night they are called ‘night sweats’ and can cause significant sleep disturbances. Episodes of vasomotor symptoms can last for a few minutes and can be associated with perspiration, flushing, chills, anxiety, and even heart palpitations.

While symptoms can vary greatly in their intensity and frequency, they typically are most debilitating during the earlier years of menopause, but for some women they may persist indefinitely.

Dr Faubion states that multiple studies have shown that HRT is very effective for VMS management. In addition, indications for use of menopausal hormone therapy include genitourinary syndromes such as vaginal dryness, painful urination, or painful sex, and prevention of bone loss and reduction of fracture risk.

She also makes the observation that there is evidence that would suggest maybe a transdermal route for administration of the hormone therapy is safer than an oral route.

Are you confused?

If you’re now confused, you are in good company. So much so that in the same issue of JAMA that published the USPSTF study, scientists from the University of California in San Francisco published an editorial  decrying this focus on chronic disease prevention because of the confusion it causes women.

From our own knowledge, many menopausal women have been able to gain significant relief from the main symptoms of VMS, vaginal dryness, painful urination, or painful sex, using some simpler alternatives available off-the-shelf. These can help you before you have been able to reconcile these two positions. We are the official online distributor for AndroFeme®, and ProFeme® pharmaceutical-grade hormone replacement therapy creams that allow you to follow the transdermal route for administration of two of the hormones you need during menopause. AndroFeme® 1% (for testosterone) and ProFeme® 10% ( for progesterone) creams are applied topically for maximum absorption and optimal effect.

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