Guidelines NICE menopause guidance supports the use of transdermal oestrogen preparations for vasomotor symptom control particularly in patients who are at risk of VTE, including those with a BMI over 30 kg/m2.16*
*Oestrogel is contraindicated if there is previous or current VTE.

Hormone Replacement Therapy (HRT) is recommended as an effective treatment for managing oestrogen deficiency symptoms associated with the menopause16

In 2015, the National Institute for Health and Care Excellence (NICE) published the NG23 guideline, titled Menopause, diagnosis and management, which makes the following recommendations for the management of menopause:16

  • Adopt an individualised approach at all stages of diagnosis, investigation and management of menopause16
  • Offer women HRT for vasomotor symptoms after discussing with them the short-term (up to 5 years) and longer-term benefits and risks16
  • Consider HRT to alleviate low mood that arises as a result of the menopause16
  • Offer a choice of HRT preparations as follows:16
    • oestrogen and progestogen to women with a uterus
    • oestrogen alone to women without a uterus
NICE menopause guidance supports the use of transdermal oestrogen preparations for vasomotor symptom control particularly in patients who are at risk of VTE, including those with a BMI over 30 kg/m2.16

Further guidelines &
recommendations on menopause

Primary Care Women’s Health Forum (PCWHF) guidelines23

There is robust evidence demonstrating that transdermal oestrogen in association with micronised progesterone could represent optimal HRT regimen23

International Menopause Society governing principles on HRT:24

  • HRT remains an effective therapy for vasomotor symptoms and urogenital atrophy compared to associated pharmacotherapies and non-pharmacotherapies*
  • Other menopause-related complaints, such as joint and muscle pains, mood swings, sleep disturbances and sexual dysfunction (including reduced libido) may improve during HRT
  • Quality of life and sexual function may also improve

*Androgen therapies, SERMS, complementary therapies, non-pharmacological and lifestyle interventions, SSRIs, SNRIs, antiepileptic drugs and other centrally acting drugs

References:

2. Panay N, Post Reprod Health 2014;20(2):69-72.

16. NICE Menopause: diagnosis and management. NICE guideline Published: 12 November 2015. Available from www.nice.org.uk/guidance/ng23 Last accessed: May 2021.

17. Utrogestan Summary of Product Characteristics. Available from https://www.medicines.org.uk/emc/product/352/smpc Last accessed: May 2021.

18. Fournier A, et al. Am J Epidemiol 2014;180(5):508-517.

19. Cyclogest 200mg Summary of Product Characteristics. Available from https://www.medicines.org.uk/emc/medicine/15056 Last accessed: May 2021.

20. Cyclogest 400mg Summary of Product Characteristics. Available from https://www.medicines.org.uk/emc/product/5569/smpc Last accessed: May 2021.

21. Crinone Summary of Product Characteristics. Available from https://www.medicines.org.uk/emc/product/1283/smpc Last accessed: May 2021.

22. Lutigest Summary of Product Characteristics. Available from https://www.medicines.org.uk/emc/history/29749 Last accessed: May 2021.

23. PCWHF Easy HRT Prescribing Guide. Available from https://www.shropscommunityhealth.nhs.uk/content/doclib/13642.pdf Last accessed: June 2021

24. Baber RJ, et al. Climacteric 2016;19(2):109-150.