The most effective therapies for menopause symptoms can have serious side effects and individual women need better information to help them make a decision on what is best for them, a National Institutes of Health consensus panel said Wednesday. The group called for more research involving a variety of women and therapies.
For years hormone replacement therapy was offered as an effective treatment for such symptoms as hot flashes and night sweats.
Use of hormones plummeted after 2002, when a major study found hormone therapy slightly raised users’ risks of heart attack, stroke and breast cancer.
But as many as one-fourth of women who stopped using the hormones returned to them because of debilitating symptoms.
Risk-benefit analyses are important for women whose symptoms create a burden on daily life, the NIH panel said in a preliminary draft statement. “These women may be willing to assume greater risk for the sake of reducing these symptoms.”
Balancing risks and benefits
For most women menopause occurs between the ages of 40 and 58 and its often difficult to determine which symptoms are caused by the change in life and which result from the aging process, the panel noted.
Hot flashes, night sweats and vaginal dryness are strongly associated with menopause and there is also evidence linking sleep disturbances, the panel reported. It found less evidence that menopause also leads to mood swings, difficulty thinking, back pain and tiredness. Studies were mixed as to whether urinary incontinence was a symptom of menopause.
The panel said that vaginal dryness is associated with some sexual dysfunction, while other sexual problems, including loss of libido, are more related to aging.
Decision-making on menopause treatment requires balancing risks and benefits, the committee said.
The panel’s draft statement suggested that women with a history of breast cancer, with an elevated risk of breast or ovarian cancer and those at high risk of cardiovascular disease may be motivated to seek therapies other than hormones.
While there are alternative treatments, many have not been well studied, said the panel, concluding that more research is needed.
