| Abstract: |
This article presents the position statement of the American Association of Clinical Endocrinologists (AACE) on the diagnosis and treatment of menopause. The authors first review the current role of hormone replacement therapy (HRT) for management of menopause, discussing the treatment of symptomatic women, the effect of HRT on bone mass and preventing fractures, cancer related to HRT, vascular and thromboembolic disease, dementia, nonhormonal therapy, androgen therapy, the indications and contraindications for HRT, and administration and dosage of estrogens and progestogens. The guidelines then outline the risks associated with short-term and long-term HRT, including venous thromboembolic disease, endometrial cancer, breast cancer, and stroke. HRT may also prevent some of the consequences of aging and menopause, including osteoporosis, dementia, and cardiovascular disease. The guidelines then consider nonhormonal therapy for menopause, notably for the management of vasomotor symptoms, or hot flashes, and androgen deficiency in postmenopausal women. The authors conclude that in selected, symptomatic, postmenopausal women, estrogen replacement alone may not be adequate therapy but should be implemented first. Combined estrogen-androgen therapy may be used in those patients who continue to have symptoms. |