Menopause treatment review provides new clarity for women and health practitioners
A systematic review of menopause guidelines led by Professor Susan Davis AO of the School of Public Health and Preventive Medicine, published in BMJ Sexual & Reproductive Health, has clarified menopause symptoms and how to best treat them when needed.
Clinicians rely on best practice guidelines, plus position and consensus statements, to inform their practice.
However, a formal appraisal of the quality, completeness and consistency of menopause guidance papers had not previously been undertaken.
This new systematic review formally appraised the quality, completeness, and consistency of all published best-practice guides on menopause over the past ten years. It provides a comprehensive overview of consensus between guidance documents, especially concerning menopause assessment and management.
The review found that the guidelines agree that the main symptoms of perimenopause and menopause are flushes and sweats, disturbed sleep, musculoskeletal pain, decreased sexual function or desire, and mood disturbance, including low mood, mood changes or depressive symptoms.
It reaffirms that clinicians can prescribe menopausal hormone therapy for the treatment of bothersome flushes/sweats, mood disturbance, and vaginal symptoms (topical hormone therapy) and for the prevention of bone loss, but that it should not be used to treat clinical depression, cognitive symptoms or for the prevention of heart disease or dementia.
Compounded hormones were also seen as potentially unsafe. While hypnosis and cognitive behaviour therapy are recommended for menopausal symptoms, there are also consistent warnings about the effectiveness of other complementary therapies, which are still as yet unproven as safe.
Areas of consensus regarding menopause management highlighted by the review should provide reassurance for both clinicians and women regarding the availability of evidence-based therapeutic options and when these can be safely used. Also, further research and guidance are needed for several non-hormonal therapies and the management of perimenopause.
Professor Davis said that navigating menopause has become a hot topic amongst women and healthcare providers, yet sourcing credible information is challenging. “Even journal papers and clinical guidelines often provide conflicting information”, she said. “This work provides clarity for women and their clinicians with respect to consensus, uncertainty, and disagreement in menopause care, and identifies where further research is warranted.”
Read the research paper.
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