Menopause: The Journal of The North American Menopause Society
Vol. 17, No. 2, pp. 242/255
* 2010 by The North American Menopause Society
Estrogen and progestogen use in postmenopausal women: 2010
position statement of The North American Menopause Society
Objective: To update for both clinicians and the lay public theevidence-based position statement published by
The North American Menopause Society (NAMS) in July 2008 regarding its recommendations for menopausal
hormone therapy (HT) for postmenopausal women, with consideration for the therapeutic benefit-risk ratio at
various times through menopause and beyond.
Methods: An Advisory Panel of clinicians and researchers expert in the field of women_s health wasenlisted to
review the July 2008 NAMS position statement, evaluate new evidence through an evidence-based analysis, and
reach consensus on recommendations. The Panel_s recommendations were reviewed and approved by the NAMS
Board of Trustees as an official NAMS position statement. Also participating in the review process were other
interested organizations who then endorsed the document.Results: Current evidence supports a consensus regarding the role of HT in postmenopausal women, when
potential therapeutic benefits and risks around the time of menopause are considered. This paper lists all these areas
along with explanatory comments. Areas that vary from the 2008 position statement are noted. A suggested reading
list of key references published since the last statement is alsoprovided.
Conclusions: Recent data support the initiation of HT around the time of menopause to treat menopause-related
symptoms; to treat or reduce the risk of certain disorders, such as osteoporosis or fractures in select postmenopausal
women; or both. The benefit-risk ratio for menopausal HT is favorable for women who initiate HT close to
menopause but decreases in older women and with timesince menopause in previously untreated women.
Key Words: Bioidentical hormones Y Breast cancer Y Cardiovascular disease Y Cognitive decline Y Coronary
heart disease Y Dementia Y Depression Y Diabetes mellitus Y Endometrial cancer Y Estrogen Y Estrogen progestogen
therapy Y Estrogen therapy Y Hormone replacement therapy Y Hormone therapy Y Menopause Y Mood Y NAMS Y
Osteoporosis Y Ovarian cancerY Perimenopause Y Postmenopause Y Premature menopause Y Premature ovarian
insufficiency Y Progestogen Y Sexual function Y Stroke Y Total mortality Y Urinary health Y Quality of life Y Vaginal
atrophy Y Vaginal health Y Vasomotor symptoms Y Venous thromboembolism Y Women_s Health Initiative.
This NAMS position statement has been endorsed by: HealthyWomen (formerly the National Women_sHealth
Resource Center), Asociacion Mexicana para el Estudio del Climaterio (AMEC), Society of Obstetricians and
Gynaecologists of Canada (SOGC) The Endocrine Society, American Medical Women_s Association (AMWA),
and National Association of Nurse Practitioners in Women_s Health (NPWH).
Received December 17, 2009; revised and accepted December 21, 2009.
The Board of Trustees ofThe North American Menopause Society
(NAMS) developed this position statement with assistance from the
following Advisory Panel: Wulf H. Utian, MD, PhD, DSc(Med), NCMP
(Chair); Gloria A. Bachmann, MD; Elizabeth Battaglino Cahill;1 J.
Christopher Gallagher, MD; Francine Grodstein, ScD; Julia R. Heiman,
PhD, ABPP; Victor W. Henderson, MD, MS, NCMP; Howard N.
Hodis, MD; Richard H. Karas, MD,PhD; JoAnn E. Manson, MD,
DrPH; Julio H. Morfın-Martın, MD;2 Robert L. Reid, MD;3 Richard J.
Santen, MD;4 Peter J. Schmidt, MD; Cynthia A. Stuenkel, MD, NCMP;
Norma Jo Waxman, MD;5 and Susan Wysocki, WHNP-BC, FAANP.6
Approved by the NAMS Board of Trustees on December 16, 2009.
Address correspondence to: NAMS, 5900 Landerbrook Dr., Suite 390,
Mayfield Heights, OH 44124, USA. E-mail:...
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