Role of progestogen in hormone therapy for postmenopausal women: position statement of The North American Menopause Society
Role of progestogen in hormone therapy for postmenopausal women: position statement of The North American Menopause Society
31st March 2003
The North American Menopause Society - Private Nonprofit Organization
Summary,
GUIDELINE OBJECTIVE(S)
Postmenopausal women in North America
INTERVENTIONS AND PRACTICES CONSIDERED
Benefits and risks of adding progestogens to estrogen therapy in postmenopausal women, the clinical goal of which is to provide endometrial protection while maintaining estrogen benefits and minimizing progestogen-induced sided effects, particularly uterine bleeding.
The North American Menopause Society - Private Nonprofit Organization
Summary,
GUIDELINE OBJECTIVE(S)- To create an evidence-based position statement regarding the role of progestogen in postmenopausal hormone therapy (estrogen plus a progestogen, or EPT) for the management of menopause-related symptoms
- To provide an update on clinical information relating to progestogens and offer a reasonable approach regarding their use in combination with estrogen in postmenopausal women
Postmenopausal women in North America
INTERVENTIONS AND PRACTICES CONSIDERED
- Determination of candidacy for treatment
- Selection of treatment product, such as:
- Progestogens:
- Progesterone (micronized)
- Oral capsule (Prometrium)
- Vaginal gel (Prochieve)
- Progestin
- Progesterone (micronized)
- Oral tablet
- medroxyprogesterone acetate (Provera, Gen-Medroxy, Alti-MPA, Novo-Medrone)
- norethindrone or norethisterone (Micronor, Nor-QD)
- norethindrone acetate (Aygestin, Norlutate)
- norgestrel (Ovrette)
- Intrauterine system
- levonorgestrel
- Combination estrogen-progestin products
- Oral continuous-cyclic regimen
- Conjugated equine estrogens PLUS medroxyprogesterone acetate (Premphase)
- Oral continuous-combined regimen
- Oral continuous-cyclic regimen
- Conjugated equine estrogens PLUS medroxyprogesterone acetate (Prempro, Premplus)
- Ethinyl estradiol PLUS norethindrone acetate (Femhrt)
- 17beta-estradiol PLUS norethindrone acetate (Activella)
- Progestogens:
- Oral intermittent-combined regimen
- 17beta-estradiol PLUS norgestimate (Ortho-Prefest)
- Transdermal continuous-combined regimen
- 17beta-estradiol PLUS norethindrone acetate (CombiPatch, Estalis)
- Transdermal continuous-cycle regimen
- 17beta-estradiol PLUS norethindrone acetate (Estalis Sequi, Estracomb)
- Management of side effects by tailoring progestogen type, dosage, or rate of administration, or the EPT regimen.
Benefits and risks of adding progestogens to estrogen therapy in postmenopausal women, the clinical goal of which is to provide endometrial protection while maintaining estrogen benefits and minimizing progestogen-induced sided effects, particularly uterine bleeding.
