Hormone therapy at menopause: the 2023 position statement

The 2023 Menopause Society (NAMS) Position Statement reaffirms hormone therapy as the most effective treatment for bothersome vasomotor symptoms (hot flashes, night sweats) and genitourinary symptoms of menopause. For women under 60 or within ten years of menopause onset, without contraindications, the benefit-risk balance is favourable for systemic use.

Caution applies to personal or family history of hormone-sensitive cancer, prior venous thromboembolism, active liver disease and uncontrolled cardiovascular risk factors. These are clinical decisions made with the prescriber, not at a counter.

Compounded bioidentical hormones have a role specifically where the dose or form listed products cannot provide — for example a precise dose or a route that suits the patient. They should always be used within a prescription and a clinical plan, not as a substitute for guideline-based care.