NAMS supports judicious use of systemic hormone therapy even after age 65

June 10, 2015

As new research continues to document the incidence of bothersome hot flashes lasting into the mid-60s for many women, the medical industry has had to rethink the way it approaches menopause therapy. As a result, earlier this month The North American Menopause Society (NAMS) issued its statement on the continuing use of systemic hormone therapy after age 65.

'The official position of NAMS is that there shouldn't be hard and fast rules against hormones after age 65,' said Wulf Utian, M.D., medical director for NAMS. 'Yes, there may be safety concerns, and the Society does recommend that a woman use the lowest dose of hormones for the time appropriate to meet her needs. But we know that, under some circumstances, hormone therapy can be appropriate for over age 65, such as those instances when the benefits of treating outweigh the risks or when a woman has a high risk of bone fractures and can't take other bone drugs or can't withstand their side effects.'

Utian points out the challenge that many Medicare plans, insurance companies and healthcare providers have not kept up with the latest studies, such as the one being published in the July 2015 print edition of Menopause, the journal of NAMS ('Moderate to severe vasomotor and sexual symptoms remain problematic for women aged 60 to 65 years.') Rather, they often deny coverage or refuse to prescribe hormone therapy because of supposed safety concerns, justifying that position on the basis of a standard list of medications that may harm older people, known as the Beers list, which includes hormones.

'The Beers list wasn't meant to be a hard and fast rule,' said Utian. 'And, in fact, it has changed over time. In 2012, for example, it added a new category of medications that should be used 'with caution'. And that's just how they should be used, fully understanding all the risks and having your doctor monitor you closely for any problems. That's what we call 'judicious use.''

The large study being published in Menopause is just one of several to quantify how prevalent troublesome hot flashes are for women at different ages. It included 2,000 women 40 to 65 years old who were representative of the Australian population.

Today, many guidelines still recommend against using systemic hormones for women more than 10 years after menopause or after age 60 and to use them only for a limited time—ideally three to five years. But that leaves a group of women older than age 60 who have really bothersome symptoms without a proven option.

The disconnect between guideline recommendations and real-world clinical practice and the low utilization of effective non-hormonal therapies for hot flashes demonstrate that menopause has gone 'off the radar' as an important health issue and, as a result, it remains largely undertreated, according to the study's authors.

'The use of should be individualized and not discontinued solely based on a woman's ,' said Dr. Utian. 'NAMS encourages all women bothered by their symptoms to seek the help they need and consider all of their options with the guidance of their clinician.'

Explore further: When I'm 64—I'll still have hot flashes?

Related Stories

When I'm 64—I'll still have hot flashes?

March 2, 2015

Some 40% of women 60 to 65 years old still have hot flashes. For many, the hot flashes are occasional and mild, but for some, they remain really troublesome, shows a new study just published in Menopause, the journal of The ...

Hot flashes take toll on life, health, and work

February 22, 2013

Hot flashes put a damper on women's health and productivity at work and pump up the cost of health care. A study published online this month in Menopause, the journal of the North American Menopause Society (NAMS), has put ...

PMS may spell menopause symptoms later—but not hot flashes

May 21, 2014

Having premenstrual syndrome (PMS) before menopause does not mean women will be troubled by hot flashes afterward. But they may face more menopause complaints other than hot flashes, such as trouble with memory and concentration, ...

Recommended for you

Losing sleep over climate change

May 26, 2017

Climate change may keep you awake—and not just metaphorically. Nights that are warmer than normal can harm human sleep, researchers show in a new paper, with the poor and elderly most affected. According to their findings, ...

Vitamin D supplements could help pain management

May 23, 2017

Vitamin D supplementation combined with good sleeping habits may help manage pain-related diseases. This paper published in the Journal of Endocrinology, reviews published research on the relationship between vitamin D levels, ...

Recommended daily protein intake too low for the elderly

May 23, 2017

You can find the recommended dietary allowance (RDA) on the nutrition labels of all your processed food. Food manufacturers are obliged to list the nutritional value of their products, and therefore must mention the percent ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.