Effects of HRT on people going through menopause assessed for guidance update

Nice has outlined what aspects of menopause care will be updated in upcoming guidance, including areas where more research is needed.

26 May 2022

The effects of hormone replacement therapy on the health of people going through the menopause are to be assessed to inform a forthcoming guidance update.

The National Institute for Health and Care Excellence (Nice) published a “scope” of its upcoming menopause guidance on Friday.

This sets out new areas of evidence that Nice will look at before it considers making new recommendations or updating existing ones.

One area identified for inclusion relates to “managing menopausal symptoms”, including through cognitive behavioural therapy and interventions to manage genitourinary symptoms.

It will also look at the effects of HRT on “overall health outcomes”.

Nice, a non-departmental public body which develops standards and publishes guidance for health, public health and social care workers, added that the National Institute for Health and Care Research (NIHR) had agreed to look at new research into whether testosterone helps to manage menopausal symptoms beyond altered sexual function.

Dr Gail Allsopp, Nice interim chief medical officer, said: “We recognise the profound impact, ​both physically and psychologically, that menopause can have and ​the need for updated guidance.

“​We are working at pace on this guideline update to ​ensure ​that its impact ​can be realised as soon as possible.

“We work closely with our stakeholders at the interface of health and care, and after highlighting the gap in the evidence for the use of testosterone, I am delighted that our partners at NIHR have agreed to scope further research into whether testosterone helps to manage menopausal symptoms beyond altered sexual function.”

Minister for women’s health Maria Caulfield said: “Most women will experience menopausal symptoms – some of these can be quite severe and have a significant impact on their everyday activities.

“It’s crucial these can be managed effectively to enable women to continue living their lives and this step forward will ensure healthcare professionals continue to have access to the most up-to-date evidence and recommendations on menopause care.”

As well as identifying a need for further research into testosterone, Nice says there are a number of areas of new evidence identified that could affect existing menopause recommendations.

It says these will now be looked at by an independent committee of experts.

The new evidence looked at in the guideline update will cover women, non-binary and trans people with menopause aged 40 and older, and will include perimenopause and postmenopause.

No new evidence was identified about people with premature ovarian insufficiency, so the existing recommendations will remain in the updated guidelines.

It will also look at inequalities relating to protected characteristics or other characteristics that might impact people’s access to care, their experience of care and their menopause process, such as age, disability, ethnicity, socioeconomic status, and gender identity.

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