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Menopause can be a challenging time of life, with distressing symptoms that affect quality of life. Endocrinologist Susannah O’Sullivan describes how to tailor treatment to each individual, with a focus on menopausal hormone therapy
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1. Lawton BA, Rose SB, Cormack DM, et al. The menopause symptom profile of Maori and non-Maori women in New Zealand. Climacteric 2008;11(6):467–74.
2. Alblooshi S, Taylor M, Gill N. Does menopause elevate the risk for developing depression and anxiety? Results from a systematic review. Australas Psychiatry 2023;31(2):165–73.
3. Hirschberg AL, Bitzer J, Cano A, et al. Topical estrogens and non-hormonal preparations for postmenopausal vulvovaginal atrophy: An EMAS clinical guide. Maturitas 2021;148:55–61.
4. Baber RJ, Panay N, Fenton A, et al. 2016 IMS recommendations on women's midlife health and menopause hormone therapy. Climacteric 2016;19(2):109–50.
5. Mehta J, Kling JM, Manson JE. Risks, benefits, and treatment modalities of menopausal hormone therapy: Current concepts. Front Endocrinol (Lausanne) 2021;12:564781.
6. Davis SR, Baber RJ. Treating menopause – MHT and beyond. Nat Rev Endocrinol 2022;18(8):490–502.
7. The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The 2017 hormone therapy position statement of The North American Menopause Society. Menopause 2017;24(7):728–53
8. Panay N, Ang SB, Cheshire R, et al. Menopause and MHT in 2024: addressing the key controversies - an International Menopause Society white paper. Climacteric 2024;27(5):441–57.
9. Kotsopoulos J, Gronwald J, Karlan BY, et al. Hormone replacement therapy after oophorectomy and breast cancer risk among BRCA1 mutation carriers. JAMA Oncol 2018;4(8):1059–65.
10. Boardman HM, Hartley L, Eisinga A, et al. Hormone therapy for preventing cardiovascular disease in post-menopausal women. Cochrane Database Syst Rev 2015(3):CD002229.
11. Olie V, Plu-Bureau G, Conard J, et al. Hormone therapy and recurrence of venous thromboembolism among postmenopausal women. Menopause 2011;18(5):488–93.
12. Vinogradova Y, Coupland C, Hippisley-Cox J. Use of hormone replacement therapy and risk of venous thromboembolism: nested case-control studies using the QResearch and CPRD databases. BMJ 2019;364:k4810.
13. Ugras SK, Layeequr Rahman R. Hormone replacement therapy after breast cancer: Yes, No or maybe? Mol Cell Endocrinol 2021;525:111180.
14. Oliver-Williams C, Glisic M, Shahzad S, et al. The route of administration, timing, duration and dose of postmenopausal hormone therapy and cardiovascular outcomes in women: a systematic review. Hum Reprod Update 2019;25(2):257–71.
15. Fournier A, Berrino F, Clavel-Chapelon F. Unequal risks for breast cancer associated with different hormone replacement therapies: results from the E3N cohort study. Breast Cancer Res Treat 2008;107(1):103–11.
16. Formoso G, Perrone E, Maltoni S, et al. Short-term and long-term effects of tibolone in postmenopausal women. Cochrane Database Syst Rev 2016;10:CD008536.
17. Palacios S, Mejia Rios A. Bazedoxifene/conjugated estrogens combination for the treatment of the vasomotor symptoms associated with menopause and for prevention of osteoporosis in postmenopausal women. Drugs Today (Barc) 2015;51(2):107–16.
18. Avis NE, Crawford SL, Greendale G, et al. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med 2015;175(4):531–39.
19. Ockene JK, Barad DH, Cochrane BB, et al. Symptom experience after discontinuing use of estrogen plus progestin. JAMA 2005;294(2):183–93.
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