3 August 2009

As new evidence has emerged over the last decade there has been debate about the safest and most effective treatment options for managing the symptoms of menopause.

The National Prescribing Service (NPS) says the decision about which treatments to use should be made jointly between the health professional and the patient.

“In order to be part of the decision-making process about their treatment, women need to be given all information about different options relevant to their own experience of menopause,” NPS Senior Adviser, Quality Use of Medicines, Judith Mackson said.

Concerns about the potential adverse affects associated with hormone replacement therapy have led to an increased interest in non-hormonal therapies. While many women often think complementary medicines are safer, the evidence is still inconclusive and there have been reports of adverse effects and interactions between complementary medicines with conventional medicines.

In its latest education program, Therapeutic choices for menopausal symptoms, NPS advises that oestrogen-based hormone replacement therapy is the most effective treatment for menopausal symptoms, if a decision is made to use drug therapy.

“Research indicates that oestrogen with or without progestogen can result in up to 75 per cent reduction in hot flush frequency per week compared to placebo. Health professionals need to educate and reassure women on the potential benefits of hormone replacement therapy and risks associated with its long term use,” Ms Mackson said.

Although most women reach menopause between the ages of 40 and 58 years, changes in periods can start several years earlier. The symptoms of menopause include hot flushes and/or night sweats, vaginal dryness or perhaps sleep disturbances.

Therapeutic choices for menopausal symptoms reinforces the following:

• Discuss each woman’s goals and concerns about menopause and her treatment preferences
• Oestrogen with or without progestogen is the most effective treatment for women with menopausal symptoms
• Consider potential benefits and harms and assess cardiovascular risk
• Tailor the dose and duration of therapy according to individual symptoms and existing risks
• Inform women about the limited efficacy and safety data on alternative medicines.

As part of the therapeutic program, NPS provides health professionals with:

• NPS News (64) - Therapeutic choices for menopausal symptoms
• Case study (59) - Optimising quality of life during menopause
• Prescribing Practice Review (47) - Therapeutic choices for menopausal symptoms (to be published September 2009)
  
• One-on-one educational visiting by NPS Facilitators
• Small group discussions led by NPS Facilitators.

“Oestrogen-based hormone replacement therapy has benefits and harms that vary significantly between women. By providing personalised information, prescribers can assist women to make informed choices,” Ms Mackson said.

For more information visit www.nps.org.au, call NPS on (02) 8217 8700 or email info@nps.org.au.

ENDS

The National Prescribing Service Limited (NPS) is an independent, non-profit organisation for Quality Use of Medicines funded by the Australian Government Department of Health and Ageing.