The British Menopause Society & Women’s Health Concern 2020 recommendations on hormone replacement therapy in menopausal women

The British Menopause Society & Women’s Health Concern 2020 recommendations on hormone replacement therapy in menopausal women

The menopause transition can have a considerable impact on many women. The majority of women will experience menopausal symptoms, and for a significant proportion troublesome symptoms may continue long-term. Hormone replacement therapy (HRT) is the most commonly used treatment for managing menopausal symptoms and has been shown to be the most effective intervention in this context.

This updated version of The British Menopause Society and Women’s Health Concern recommendations on HRT evaluates the evidence on the role of HRT in managing menopausal symptoms as well as that of alternative therapies. It also reviews the effects of HRT on bone, cardiovascular and cognitive function. In addition, the document assesses the evidence on the risks associated with HRT including venous thromboembolism (VTE), stroke and cancer and discusses the publication from the Collaborative Group on Hormonal Factors in Breast Cancer published in the Lancet in 2019 and the findings from the WHI long-term randomised clinical trials published in 2020.

The document also reviews progestogen regimens and the management of unscheduled bleeding on HRT and concludes with a summary of recommendations.

The BMS key recommendation is that all women should be able to access advice on how they can optimise their menopause transition and the years beyond. There should be a holistic and individualised approach in assessing and advising women, with particular reference to lifestyle advice and diet modification. This should be an opportunity to discuss the advantages and disadvantages of their management options including HRT and complementary therapies.


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