Managing Menopause: A Hot Topic

At the conclusion of this continuing education activity, the participant will be able to:

1. Describe the spectrum of symptoms present in a perimenopausal female

2. Analyze the risk/benefit ratio of hormone replacement therapy for the management of postmenopausal symptoms

3. Recommend therapeutic regimens for the management of perimenopausal vasomotor symptoms

Menopause is an inevitable life event for all females. The peri-menopausal transition can have dramatic effects on female systemic health, cognition, mood, energy, and quality of life. The approach to management requires a thoughtful understanding of both the risks and benefits associated with treatment. For years, hormone replacement therapy was looked at as a fountain of youth, a treatment that could minimize troublesome menopause symptoms, enhance bone growth, and improve quality of life through effects on mood and cognition. Theorizing this possible benefit, the Women’s Health Initiative Trial was implemented, with the hypothesis that HRT would dramatically reduce risks of CVD and cancer in postmenopausal women. Interestingly, the WHI was stopped prematurely due to an increased risk of CVD and breast cancer in certain populations. After this trial, the use of hormone therapy fell dramatically, and estrogen and progestin-based therapies to treat menopause largely fell out of favor, posing that the risks of HRT did not outweigh the benefits. Almost twenty years after the WHI, clinicians remain hesitant to implement systemic hormone therapy for patients with peri-menopausal symptoms, and the results of the study still spark debate in the medical community. This is likely due to the notion that conflicting thoughts, and perspectives still prevail, and there is a lack of clear, consensus guidelines on the approach to management.The availability of recent trial data that demonstrate differing outcomes of hormone replacement therapy based upon patient characteristics should not be overlooked, as new data suggests that the benefits of HRT in improving quality of life, reducing bone loss, and reducing peri-menopausal symptoms can outweigh the risks in certain patients. The purpose of this session is to introduce the attendee to the previous viewpoints on HRT, the recent clinical trial data that has rebuked many previous perspectives, and discuss hot topics in the treatment of menopause including Vitamin D therapy, osteoporosis, management of CVD, and finally the emotional toll of menopause with a focus on effects on mood, cognition, and depression. This session will provide individuals a comprehensive understanding on appropriate candidates for hormonal and non- hormonal therapies for menopause, and how to minimize the impeding effects of menopause to enhance quality of life.