Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?

We provide an evidence base and guidance for the use of menopausal hormone therapy (MHT) for the maintenance of skeletal health and prevention of future fractures in recently menopausal women. Despite controversy over associated side effects, which has limited its use in recent decades, the potentia...

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Autores: Rozenberg, S, Al-Daghri, N, Aubertin-Leheudre, M, Brandi, M-L, Cano, A, Collins, P, Cooper, C, Genazzani, A R, Hillard, T, Kanis, J A, Kaufman, J-M, Lambrinoudaki, I, Laslop, A, McCloskey, E, Palacios, S, Prieto-Alhambra, D, Reginster, J-Y, Rizzoli, R, Rosano, G, Tremollieres, F, Harvey, N C
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2020
País:España
Institución:INCLIVA
Repositorio:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
OAI Identifier:oai:incliva.fundanetsuite.com:p4659
Acceso en línea:https://incliva.portalinvestigacion.com/publicaciones/4659
Access Level:acceso abierto
Palabra clave:Cardiovascular
Epidemiology
Hormone therapy
Menopause
Osteoporosis
Safety
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spelling Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?Rozenberg, SAl-Daghri, NAubertin-Leheudre, MBrandi, M-LCano, ACollins, PCooper, CGenazzani, A RHillard, TKanis, J AKaufman, J-MLambrinoudaki, ILaslop, AMcCloskey, EPalacios, SPrieto-Alhambra, DReginster, J-YRizzoli, RRosano, GTremollieres, FHarvey, N CCardiovascularEpidemiologyHormone therapyMenopauseOsteoporosisSafetyWe provide an evidence base and guidance for the use of menopausal hormone therapy (MHT) for the maintenance of skeletal health and prevention of future fractures in recently menopausal women. Despite controversy over associated side effects, which has limited its use in recent decades, the potential role for MHT soon after menopause in the management of postmenopausal osteoporosis is increasingly recognized. We present a narrative review of the benefits versus risks of using MHT in the management of postmenopausal osteoporosis. Current literature suggests robust anti-fracture efficacy of MHT in patients unselected for low BMD, regardless of concomitant use with progestogens, but with limited evidence of persisting skeletal benefits following cessation of therapy. Side effects include cardiovascular events, thromboembolic disease, stroke and breast cancer, but the benefit-risk profile differs according to the use of opposed versus unopposed oestrogens, type of oestrogen/progestogen, dose and route of delivery and, for cardiovascular events, timing of MHT use. Overall, the benefit-risk profile supports MHT treatment in women who have recently (<10years) become menopausal, who have menopausal symptoms and who are less than 60years old, with a low baseline risk for adverse events. MHT should be considered as an option for the maintenance of skeletal health in women, specifically as an additional benefit in the context of treatment of menopausal symptoms, when commenced at the menopause, or shortly thereafter, in the context of a personalized benefit-risk evaluation.SPRINGER LONDON LTD2020info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://incliva.portalinvestigacion.com/publicaciones/4659OSTEOPOROSIS INTERNATIONALISSN: 0937941XISSNe: 14332965reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVAinstname:INCLIVAInglésinfo:eu-repo/semantics/openAccessoai:incliva.fundanetsuite.com:p46592026-06-07T16:35:31Z
dc.title.none.fl_str_mv Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
title Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
spellingShingle Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
Rozenberg, S
Cardiovascular
Epidemiology
Hormone therapy
Menopause
Osteoporosis
Safety
title_short Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
title_full Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
title_fullStr Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
title_full_unstemmed Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
title_sort Is there a role for menopausal hormone therapy in the management of postmenopausal osteoporosis?
dc.creator.none.fl_str_mv Rozenberg, S
Al-Daghri, N
Aubertin-Leheudre, M
Brandi, M-L
Cano, A
Collins, P
Cooper, C
Genazzani, A R
Hillard, T
Kanis, J A
Kaufman, J-M
Lambrinoudaki, I
Laslop, A
McCloskey, E
Palacios, S
Prieto-Alhambra, D
Reginster, J-Y
Rizzoli, R
Rosano, G
Tremollieres, F
Harvey, N C
author Rozenberg, S
author_facet Rozenberg, S
Al-Daghri, N
Aubertin-Leheudre, M
Brandi, M-L
Cano, A
Collins, P
Cooper, C
Genazzani, A R
Hillard, T
Kanis, J A
Kaufman, J-M
Lambrinoudaki, I
Laslop, A
McCloskey, E
Palacios, S
Prieto-Alhambra, D
Reginster, J-Y
Rizzoli, R
Rosano, G
Tremollieres, F
Harvey, N C
author_role author
author2 Al-Daghri, N
Aubertin-Leheudre, M
Brandi, M-L
Cano, A
Collins, P
Cooper, C
Genazzani, A R
Hillard, T
Kanis, J A
Kaufman, J-M
Lambrinoudaki, I
Laslop, A
McCloskey, E
Palacios, S
Prieto-Alhambra, D
Reginster, J-Y
Rizzoli, R
Rosano, G
Tremollieres, F
Harvey, N C
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cardiovascular
Epidemiology
Hormone therapy
Menopause
Osteoporosis
Safety
topic Cardiovascular
Epidemiology
Hormone therapy
Menopause
Osteoporosis
Safety
description We provide an evidence base and guidance for the use of menopausal hormone therapy (MHT) for the maintenance of skeletal health and prevention of future fractures in recently menopausal women. Despite controversy over associated side effects, which has limited its use in recent decades, the potential role for MHT soon after menopause in the management of postmenopausal osteoporosis is increasingly recognized. We present a narrative review of the benefits versus risks of using MHT in the management of postmenopausal osteoporosis. Current literature suggests robust anti-fracture efficacy of MHT in patients unselected for low BMD, regardless of concomitant use with progestogens, but with limited evidence of persisting skeletal benefits following cessation of therapy. Side effects include cardiovascular events, thromboembolic disease, stroke and breast cancer, but the benefit-risk profile differs according to the use of opposed versus unopposed oestrogens, type of oestrogen/progestogen, dose and route of delivery and, for cardiovascular events, timing of MHT use. Overall, the benefit-risk profile supports MHT treatment in women who have recently (<10years) become menopausal, who have menopausal symptoms and who are less than 60years old, with a low baseline risk for adverse events. MHT should be considered as an option for the maintenance of skeletal health in women, specifically as an additional benefit in the context of treatment of menopausal symptoms, when commenced at the menopause, or shortly thereafter, in the context of a personalized benefit-risk evaluation.
publishDate 2020
dc.date.none.fl_str_mv 2020
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://incliva.portalinvestigacion.com/publicaciones/4659
url https://incliva.portalinvestigacion.com/publicaciones/4659
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SPRINGER LONDON LTD
publisher.none.fl_str_mv SPRINGER LONDON LTD
dc.source.none.fl_str_mv OSTEOPOROSIS INTERNATIONAL
ISSN: 0937941X
ISSNe: 14332965
reponame:r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
instname:INCLIVA
instname_str INCLIVA
reponame_str r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
collection r-INCLIVA. Repositorio Institucional de Producción Científica de INCLIVA
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,812429

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