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J Korean Med Assoc > Volume 62(3); 2019 > Article
Kwon and Shin: Updated treatment guideline for hormone therapy in postmenopausal women

Abstract

Since menopause hormone therapy was first introduced, it has been widely used worldwide as the most effective treatment for vasomotor symptoms in menopausal women and for genitourinary syndrome of menopause. Menopause hormone therapy has been shown to prevent bone loss and fracture, but it may additionally offer various benefits for numerous other symptoms. The benefit-to-risk ratio of menopause hormone therapy is most favorable for women aged younger than 60 years or who are within 10 years of menopause onset and have no contraindications. Longer durations of therapy should be limited to patients with documented indications, such as persistent vasomotor symptoms or bone loss. For genitourinary syndrome of menopause, low-dose vaginal estrogen therapy or other therapies are recommended. Tibolone is a synthetic steroid that provides a therapeutic effect in the treatment of menopausal symptoms.

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Figure 1

Algorithm for menopausal symptom management and hormonal/non-hormonal therapy decision-making. SSRIS, selective serotonin reuptake inhibitors; SNRI, serotonin norepinephrine reuptake inhibitors.

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Table 1

Formulations and doses of estrogen for treatment of menopausal symptoms

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