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February 2016

Ten key points from NICE guideline

(National Institute for Health and Care Excellence - NICE)

1. Women should have access to evidence based information about menopause and treatment options to help them make informed, individual decisions about menopause management
2. Blood tests should not be used to diagnose perimenopause or menopause in women aged over 45
3. HRT should be offered for menopause related vasomotor symptoms and low mood
4. Clonidine or antidepressants should not be routinely offered for menopausal symptoms
5. vaginal estrogen should be offered for urogenital symptoms, even if HRT is also taken, and continued long term
6. Women should have access to specialist services when:
• treatments do not improve menopausal symptoms
• side effects persist
• concern from medical history about use of HRT
7. The decision to stop HRT should be made by each woman when she feels is the right time for her; she should not be given arbitrary limits on duration of HRT. When stopping HRT can be stopped gradually or suddenly
8. HRT does not increase risk of cardiovascular disease when started in women under age 60
9. Any increase in breast cancer risk is related to treatment duration and reduces after HRT is stopped, with HRT promoting tumour growth rather than causing tumour
10. Women with Premature Ovarian insufficiency should be offered hormonal treatment up to average age of menopause at least