The 2022 hormone therapy position statement of The North American Menopause Society.
Level 5 - mechanism / opinion, no new human data
Expert consensus position statement and clinical practice guideline
PubMed 35797481 · doi:10.1097/GME.0000000000002028
What was done
An advisory panel of clinicians and researchers in women's health convened by The North American Menopause Society (NAMS) reviewed post-2017 literature, evaluated evidence quality, and reached consensus to update the 2017 NAMS hormone therapy position statement. Recommendations were subsequently reviewed and approved by the NAMS Board of Trustees.
What was found
The abstract reports no numerical figures or effect sizes. Hormone therapy remains identified as the most effective therapy for vasomotor symptoms (VMS) and genitourinary syndrome of menopause (GSM), while also preventing bone loss and fracture. The benefit-risk ratio is favorable for women aged younger than 60 years or within 10 years of menopause onset who lack contraindications. For women initiating therapy more than 10 years post-menopause or aged older than 60 years, the benefit-risk ratio becomes less favorable due to higher absolute risks of coronary heart disease, stroke, venous thromboembolism, and dementia. Low-dose vaginal estrogen, vaginal dehydroepiandrosterone, or oral ospemifene are recommended for isolated GSM symptoms not relieved by over-the-counter products.
Why it matters
This statement provides updated clinical guidance on individualizing menopausal hormone therapy by factoring in patient age, time since menopause onset, route of administration, and treatment indications.
Limits
The abstract reports no quantitative risk estimates, confidence intervals, or details on the literature search and grading methodology. As an expert consensus position statement, it synthesizes existing literature rather than presenting primary empirical trial data.
Cited by
- supports Vaginal estrogen cream or suppositories alone ameliorate sexual symptoms but do not provide systemic bone protection or reduce vasomotor symptoms.