The American College of Obstetricians and Gynecologists has released new guidelines for treating common symptoms of menopause and perimenopause, including recommending hormone replacement therapy for many women experiencing hot flashes and night sweats.
This is the first time in more than a decade that the group, which is the leading professional organization for OB-GYN in the United States, has changed its guidance on the use of hormone therapy for menopause and perimenopause.
“Hormone replacement therapy is now the first line” for vasomotor symptoms, including hot flashes, night sweats and sleep problems, said Dr. Kameelah Phillips, an obstetrician-gynecologist and menopause specialist.
“Before, we would say, ‘Here’s an antidepressant. Make sure you practice. Why don’t you try a glass of wine?’ It hasn’t all been helpful,” Phillips said in an interview on “CBS Mornings.” “We now use hormones in a dominant way.”
How Hormone Replacement Therapy for Menopause Works
Most menopause symptoms are caused by sharp declines in the hormones estrogen and progesterone, usually in the late 40s or early 50s. These hormone drops lead to hot flashes, night sweats and other symptoms. Low levels of estrogen and progesterone can also lead to reduced bone density, increasing the risk of osteoporosis or fractures.
Hormone replacement therapy can help “eliminate those symptoms,” Phillips said.
Hormone replacement therapy can be administered in different ways, including pills, patches, sprays or gels, or a vaginal ring that can deliver doses of hormones directly into the bloodstream. Some women also benefit from low-dose vaginal estrogen therapy.
“Menopause is a normal, natural stage of life, but that does not mean women should suffer the symptoms without help,” ACOG said in a statement regarding the new recommendations.
Who can benefit from hormone replacement therapy?
Not all postmenopausal people are eligible for hormone replacement therapy. Women with a history of blood clots, stroke, or liver disease should not use them. People with a personal history of breast cancer should also avoid these therapies, according to ACOG.
A 2002 long-term study on women’s health raised concerns that hormone use could be linked to an increase in breast cancer. But that study focused on older patients who might not have started hormone replacement therapy until about a decade after menopause, said Dr. Céline Gounder, CBS News medical contributor and public health editor at KFF Health News.
More recent research shows that factors such as age and dosage may make the treatment safe for many patients. This can also help slow biological agingaccording to a 2024 study of more than 10,000 women.
ACOG recommendations state that women should begin hormone replacement therapy before age 60 or within 10 years of the onset of menopause.
Women who are not eligible for hormone replacement therapy may benefit from other treatment options. Phillips recommended seeing a trained menopause specialist.
“There are some really good non-hormonal options for these women,” Phillips said. “But that’s why it requires a conversation with your doctor.”
Gn Health
