Since the Women’s Health Initiative (WHI) reported that the risks of menopausal hormone replacement therapy (HRT) outweighed its benefits, there has been a significant reduction in the use of HRT. However, since that time, studies have suggested that many peri- and postmenopausal women experience significant symptoms for many years and that certain populations of women may benefit from HRT without significant risks.
In 2012, the North American Menopause Society (NAMS) noted that HRT carries fewer risks for younger postmenopausal women and suggested that HRT could be used safely at the lowest possible dose for the shortest time necessary (typically <5 years).
Addressing the needs of older postmenopausal women, NAMS has published a position statement indicating that the use of HRT after the age of 65 is appropriate if a woman continues to have bothersome symptoms and is unable to use other medications to manage her symptoms, provided that her clinician has determined that the benefits of HRT outweigh the risks and that she has been informed of the risks associated with HRT.
Ruta Nonacs, MD PhD