Berek Novak's Gyn 2019. Chapter 18 Menopause

 CHAPTER 18

Menopause

KEY POINTS

1 A woman in the developed world will spend approximately a third of her life beyond

menopause, so addressing the health and quality of life concerns of menopausal

women is critically important.

2 Health and quality of life concerns of menopausal and aging women include

vasomotor symptoms, symptomatic vulvovaginal atrophy, sexual dysfunction,

1022osteoporosis, cardiovascular disease, cancer, and cognitive decline.

3 Hot flashes and night sweats (vasomotor symptoms) affect up to 75% of

perimenopausal women and may last 10 years or longer.

4 Hormone therapy is the most effective treatment for vasomotor symptoms. Low-dose

paroxetine is another approved option. Lifestyle changes, relaxation response

techniques, acupuncture, soy and herbal products are popular interventions with

limited efficacy beyond placebo.

5 Contraindications to systemic hormone therapy use include known or suspected

breast or endometrial cancer, abnormal vaginal bleeding, cardiovascular disease

(including coronary heart disease, cerebrovascular disease, and thromboembolic

disorders), and active liver or gallbladder disease. Relative contraindications include

high-risk states for the above disorders.

6 The genitourinary syndrome of menopause, which includes symptomatic

vulvovaginal atrophy, affects at least 50% of menopausal women with an adverse

impact on sexual function and quality of life.

7 Vaginal application of low doses of estrogen is an effective and safe treatment of

vaginal dryness, dyspareunia, and certain urinary symptoms. Other options include

systemic hormone therapy, vaginal lubricants and moisturizers, oral ospemifene,

vaginal dehydroepiandrosterone, and pelvic physical therapy.

8 Sexual concerns are common after menopause, etiology is generally multifactorial,

and effective treatment options are available.

9 Osteoporosis and fractures increase with menopause and aging. Modifying risk

factors and pharmacologic interventions effectively prevent and treat osteoporosis

and reduce fracture risk.

10 Cardiovascular disease is an important health concern for menopausal women. A

healthy lifestyle and treatment of associated diseases including hyperlipidemia,

hypertension, and diabetes reduce risk, morbidity, and mortality.

11 Breast cancer is a major health concern for menopausal women and regular

screening is indicated.

12 Cognitive decline and dementia are highly prevalent in older women and risk

reduction should be optimized beyond menopause.

Menopause, the permanent cessation of menstruation caused by ovarian

failure, occurs at an average age of 52 years, with a range of 40 to 58 years.

Despite a great increase in the life expectancy of women, the age at menopause

has remained remarkably constant. [1] A woman in the developed world will

live approximately 30 years, or greater than a third of her life, beyond

menopause. Therefore, it is important to ensure these years are as healthy

and productive as possible. The age at menopause appears to be genetically

determined and is unaffected by race/ethnicity or age at menarche. Early

menopause describes menopause occurring between the ages of 40 and 45 years

1023and occurs in approximately 5% of women. Premature menopause describes

permanent loss of ovarian function before the age of 40, such as following

bilateral oophorectomy. Primary ovarian insufficiency (POI) describes loss

of ovarian function before the age of 40 years, which may not be permanent.

POI occurs in approximately 1% of women. Factors associated with early

menopause or POI include toxic exposures, genetic abnormalities, autoimmune

disorders, and pelvic surgery. Women who smoke experience an earlier

menopause (1), as do many women exposed to chemotherapy or pelvic radiation.

Fragile X premutations, Turner mosaic karyotypes, and ovarian surgery or

hysterectomy, despite retention of ovaries, may result in early menopause or POI

(2).

Although menopause is associated with changes in the hypothalamic and

pituitary hormones that regulate the menstrual cycle, menopause is not a

central event, but rather an indication of primary ovarian failure. At the level

of the ovary, there is a depletion of ovarian follicles, most likely secondary to

apoptosis or programmed cell death. The ovary is no longer able to respond to the

pituitary’s follicle-stimulating hormone (FSH) and luteinizing hormone (LH), and

ovarian estrogen and progesterone production ceases. The ovarian–

hypothalamic–pituitary axis remains intact during the menopausal

transition; thus, FSH levels rise in response to ovarian failure and the

absence of negative feedback from the ovary. Atresia of the follicular

apparatus, in particular granulosa cells, leads to decreased production of estrogen

and inhibin, resulting in elevated FSH levels, a cardinal sign of menopause.

Antimüllerian hormone (AMH) is produced by small ovarian follicles, so

levels decrease with declining ovarian reserve (3).

Androgen production from the ovary continues beyond the menopausal

transition caused by sparing of ovarian stroma and theca cells. Androgen

concentrations are lower in menopausal women than in women of reproductive

age. This finding appears to be associated with aging and decreased functioning

of the ovary and adrenal glands over time rather than with menopause per se.

Menopausal women continue to have low levels of circulating estrogens,

principally from peripheral aromatization of ovarian and adrenal androgens.

Adipose tissue is a major site of aromatization, so obesity affects many of the

sequelae of menopause. Obesity is a risk factor for breast cancer and a protective

factor for osteoporosis, likely as a result of the impact of higher levels of

endogenous free estrogens, though still within the menopausal range.

Menopause is defined retrospectively as the time of the final menstrual

period followed by 12 months of amenorrhea. Postmenopause describes the

period following the final menses.

The STRAW (Staging of Reproductive Aging Workshop) criteria describe

1024the changes that encompass the transition from reproductive life to

postmenopause (4). The late reproductive stage is marked by decreased fertility

and onset of menstrual cycle changes. The early menopausal transition is

characterized by increased variability in menstrual cycle lengths (≥7 days), and

the late menopausal transition by amenorrhea of ≥60 days. Early postmenopause

describes approximately 5 to 8 years after the final menstrual period and is

followed by late postmenopause. Rising FSH levels, a reduced ovarian antral

follicle count, and declining levels of inhibin-B and AMH accompany

menstrual cycle changes.

The pathophysiologic consequences of menopause may be best understood by

considering that the ovary is a woman’s only source of oocytes, her primary

source of estrogen and progesterone, and a major source of androgens.

Menopause results in infertility secondary to oocyte depletion. Ovarian cessation

of progesterone production appears to have no clinical consequences, except for

the increased risk of endometrial proliferation, hyperplasia, and cancer associated

with continued endogenous estrogen production or administration of unopposed

estrogen therapy (ET) after menopause. The effects of declining androgen

concentrations that occur with aging have yet to be determined.

The clinical consequences of menopause are related primarily to estrogen

deficiency. It is difficult to distinguish the impact of estrogen deficiency from that

of aging, as aging and menopause are inextricably linked. Studying the effects of

estrogen deficiency and replacement in young women with ovarian failure or of

drugs that suppress estrogen synthesis (such as gonadotropin-releasing hormone

antagonists) helps to distinguish between the effects of aging and estrogen

deficiency. These models are imperfect, though, and differ from natural

menopause in many ways.

[2] Principal health and quality of life concerns of menopausal women

include vasomotor symptoms, the genitourinary syndrome of menopause

(GSM), sexual dysfunction, osteoporosis, cardiovascular disease (CVD),

cancer, and cognitive decline. Options for caring for menopausal women have

increased greatly since hormone therapy (HT) was first introduced in the 1960s.

There are many choices of hormone type, dose, and method of administration. In

addition to HT, other pharmacologic options include estrogen agonist/antagonists,

centrally acting agents, and bisphosphonates. Women are requesting more

information on complementary and alternative (CAM) therapies, which are being

studied more carefully. The many options available make caring for the

postmenopausal woman more challenging and more rewarding.

HEALTH CONCERNS AFTER MENOPAUSE

1025Vasomotor Symptoms

[3] Vasomotor symptoms affect up to 75% of perimenopausal women.

Symptoms last for 1 to 2 years after menopause in most women, but may

continue for up to 10 years or longer in others (5,6). Hot flashes are the

primary reason women seek care at menopause. Hot flashes interrupt daily

activities, disrupt sleep, and disturb women at work (7,8). Many women report

difficulty concentrating and emotional lability during the menopausal transition.

Treatment of vasomotor symptoms often will improve cognitive and mood

symptoms if they are secondary to sleep disruption and resulting daytime

fatigue. The incidence of thyroid disease increases as women age; therefore,

thyroid function tests should be performed, if vasomotor symptoms are

atypical or resistant to therapy.

The physiologic mechanisms underlying hot flashes are incompletely

understood. A central event, likely in the hypothalamus, drives an increased core

body temperature, metabolic rate, and skin temperature; this reaction results in

peripheral vasodilation and sweating. The central event may be triggered by

noradrenergic, serotoninergic, and/or dopaminergic activation. Hypothalamic

neurons containing kisseptin, neurokinin B (NKB), and dynorphin receptors

(KNDy neurons) appear to play an important role in hot flashes. Peripheral

infusion of NKB intravenously induces a typical hot flash, while blocking NKB

activity reduces hot flashes (9). Although an LH surge often occurs at the time of

a hot flash, it is not causative, as vasomotor symptoms occur in women without

pituitary glands. In symptomatic postmenopausal women, hot flashes likely are

triggered by small elevations in core body temperature acting within a narrow

thermoneutral zone (10). Exactly how estrogen and alternative therapies play a

role in modulating these events is unknown. Vasomotor symptoms are a

consequence of estrogen withdrawal, not simply estrogen deficiency. For

example, a young woman with premature menopause caused by Turner syndrome

will have very high FSH levels and low estrogen levels, but will not experience

hot flashes until she is treated with estrogens and that therapy is withdrawn.

Lifestyle interventions may safely decrease vasomotor symptoms. Being in

a cool environment is associated with fewer subjective and objective hot

flashes (11), so women experiencing symptoms should be advised to keep the

room temperature low and wear light, layered clothing (see Table 18-1).

Overweight women and those who smoke often have more severe vasomotor

symptoms than women of normal weight and nonsmokers. These findings

provide additional reasons to encourage women to lose weight and stop smoking

(12). Many menopausal women are interested in trying CAM therapies for relief

of hot flashes. These are diverse medical and health care products and practices

generally not considered part of conventional medicine. Vasomotor symptoms are

1026particularly sensitive to placebo effects. Numerous nutritional supplements and

products claim to relieve hot flashes but these assertions are rarely

supported by controlled trials (13). Phytoestrogens are plant-derived substances

that may act as estrogen agonist/antagonists, with their effects modulated through

interactions with the estrogen receptor. Although they decrease hot flash severity

and frequency, symptom improvement is comparable to that seen with placebo

treatment (14). Black cohosh is another popular alternative treatment, with

efficacy similar to placebo (15).

Table 18-1 Options for the Treatment of Vasomotor Symptoms

Hormone Therapy

Estrogen therapy

Progestin therapya

Combination estrogen/progestin therapy

Combination conjugated estrogen/bazedoxifene

Nonhormonal Prescription Medications

Centrally acting alpha agonist

Clonidinea

Selective serotonin and norepinephrine reuptake inhibitors

Paroxetine

Venlafaxinea

Escitaloprama

γ-aminobutyric acid analogs

Gabapentina

Pregabalina

Nonprescription Medicationsa

Isoflavone supplements

Soy products

Black cohosh

Lifestyle Changes

Reducing body temperature

Maintaining a healthy weight

Smoking cessation

Relaxation response techniques

Yoga

1027Acupuncture

aNot U.S. Food and Drug Administration–approved for treatment of vasomotor symptoms.

Acupuncture reduces vasomotor symptoms in several studies, although a

traditional Chinese medicine approach may be no more effective than shallow or

“sham” needling techniques (16,17). Exercise, yoga, and paced respiration

demonstrated an improvement in hot flashes in several uncontrolled studies, with

additional health benefits, including stress reduction. Women may choose to use

alternative and complementary therapies for relief of symptoms, but they should

be aware that the safety and efficacy of these approaches often are unproven.

[4] Systemic ET is the most effective treatment for vasomotor symptoms (see

Table 18-2). Although low-dose formulations are often effective, younger

women and those with recent oophorectomy may require higher doses.

Progestin therapy must be given concurrently if a woman has a uterus,

although with low-dose ET, intermittent progestin treatment may be an

option. Oral contraceptives (OCPs) are an excellent option for healthy,

nonsmoking, perimenopausal women with bothersome hot flashes. The

supraphysiologic doses of estrogens and progestins in OCPs treat vasomotor

symptoms while controlling irregular bleeding. A tissue-selective estrogen

complex that combines conjugated estrogen (CE) (0.45 mg) and the

agonist/antagonist, bazedoxifene (BZA) (20 mg) (1 tablet orally daily) is

approved for the treatment of vasomotor symptoms (VMS) in menopausal

women with a uterus. BZA provides endometrial protection, so a progestin is not

needed (18).

HT should be used at the lowest effective dose for the duration necessary

to meet treatment goals. For the majority of healthy women with bothersome

hot flashes at the menopausal transition, the benefits of HT will outweigh

risks.

Because vasomotor symptoms appear to be the result of estrogen

withdrawal, rather than simply low estrogen levels, if cessation of ET is

desired, the dose should be reduced slowly over time. This recommendation is

based on clinical experience, as few controlled trials have been performed to

examine the optimal way to discontinue HT. Abruptly stopping treatment may

result in a return of disruptive vasomotor symptoms in approximately 50% of HT

users (19). The dose and dosing interval may be reduced slowly over months or

even years, depending on the patient’s symptoms. For women unable to

discontinue HT without return of bothersome symptoms, long-term use may

be an option, depending on health status, a careful review of risks and

benefits, and shared decision making (20).

1028For women who choose not to take estrogen or when it is contraindicated, other

options are available (see Table 18-1) (13). Progestin therapy alone, including

medroxyprogesterone acetate and micronized progesterone, reduces hot flash

frequency and severity (21,22). Various agents that alter central neurotransmitter

pathways reduce VMS. Agents that decrease central noradrenergic tone, such as

clonidine, decrease hot flashes, although the effect size is limited. Potential side

effects include orthostatic hypotension and drowsiness.

Table 18-2 Approved Estrogen/Progestogen Prescription Products for Menopausal

Symptoms in the United States

10291030Selective serotonin and serotonin norepinephrine reuptake inhibitors

(SSRIs/SNRIs) reduce hot flash frequency and severity and are the mainstay

of nonhormonal VMS treatment. Although paroxetine, venlafaxine, and

escitalopram have been shown in randomized controlled trials (RCTs) to be

more effective than placebo and may be used off-label (23,24), only a very

low dose of paroxetine (7.5 mg) is FDA approved for this indication (25). Side

effects of SSRIs/SNRIs include nausea, drowsiness, dry mouth, insomnia, and

sexual dysfunction. Paroxetine inhibits the enzyme system that converts

tamoxifen to its active form, so should not be used by women taking

tamoxifen for breast cancer prevention or treatment.

Gabapentin and pregabalin are γ-aminobutyric acid analogs approved for

the treatment of seizures and neuropathic pain. These agents reduce hot

flash frequency and severity significantly more than placebo in several

RCTs, so are an off-label option for VMS treatment (26,27). As side effects

include disorientation, dizziness, and drowsiness, use of gabapentin and

pregabalin is best limited to bedtime for the treatment of night sweats and

associated sleep disruption. Women principally bothered by night sweats and

disrupted sleep may benefit from sleeping medication. In an RCT, the prescription

insomnia treatment, eszopiclone, significantly improved sleep with a positive

impact on next-day functioning, mood, and quality of life (28). Antihistamines,

including diphenhydramine hydrochloride, are inexpensive, over-the-counter

agents that may improve sleep in women with bothersome night sweats.

A potential therapy for VMS is an agent that blocks hypothalamic NKB

activity. Although not yet commercially available, RCTs confirm that an oral

antagonist to the NKB receptor (NK3R) significantly reduces hot flashes

compared with placebo, independent of any hormonal effects (9).

1031Genitourinary Syndrome of Menopause

[6] GSM describes anatomic changes and symptoms secondary to estrogen

deficiency affecting the labia, vagina, urethra, and bladder (29). Symptoms

include bothersome genital irritation, dryness, and burning; urinary

urgency, dysuria, and recurrent urinary tract infections (UTIs); and dryness

and pain with sexual activity. Vulvovaginal atrophy (VVA) is a component of

GSM (30). Bothersome VVA symptoms are highly prevalent, affecting at

least 50% of menopausal women, with a significant adverse impact on

quality of life (31,32). Although vasomotor symptoms generally improve with

time, GSM typically worsens in the absence of treatment. Many effective

therapies are available for GSM/symptomatic VVA (33).

Nonhormonal vaginal products available over-the-counter are often an initial

treatment intervention. Vaginal lubricants (water, silicone, or oil based) reduce

friction and increase comfort with penetrative sexual activity, including

intercourse. Long-acting vaginal moisturizers used two to three times weekly

line the vagina, retaining moisture and reducing symptoms (34).

Activity that stretches, stimulates, and strengthens the genital area promotes

vulvovaginal health. If indicated, genital activity, with or without a partner,

should be encouraged after menopause. Pelvic physical therapy (PT) and use of

vaginal dilators effectively treat severe dyspareunia (35). The use of laser therapy

for the treatment of GSM remains controversial with few controlled trials (36,37).

[7] If nonhormonal therapies are ineffective, ET is approved for the

treatment of vaginal dryness, dyspareunia, and related symptoms. Low doses

of estrogen applied vaginally are preferred to systemic ET in the absence of

vasomotor symptoms because of minimal absorption and a high degree of

safety (33). Several formulations are available, including vaginal estradiol tablets

and creams, and a ring (see Table 18-2) (38). Low doses of vaginal estrogen

cream (0.5 g) are effective when used only two or three times weekly. An

estradiol vaginal tablet (10 μg, 4 μg) inserted twice weekly may be less messy

than estrogen cream. An estradiol-containing vaginal ring (7.5 μg per day) is

another convenient formulation, which is placed in the vagina every 3 months and

slowly releases a low dose of estradiol (39).

Endometrial safety has been confirmed with the use of low-dose vaginal

ET for up to 1 year, but long-term clinical trials have not been performed.

An analysis of data from more than 45,000 women in the Women’s Health

Initiative (WHI) Observational Study was very reassuring, with no increased risk

of endometrial cancer seen in users of vaginal ET compared with nonusers (40).

There also was no increased risk of breast cancer or CVD in vaginal ET users.

Women using vaginal ET should be reminded to report any vaginal bleeding,

and a thorough evaluation should be performed. Typically, concurrent

1032progestin therapy is not prescribed with low-dose vaginal estrogen

preparations.

Vaginal ET reduces certain urinary problems in menopausal women,

including frequency, urgency, and recurrent UTIs (41). Incontinence does

not appear to improve with vaginal ET, and is likely worsened by systemic

HT (42,43).

Studies of the low-dose estradiol vaginal ring and tablet confirm that serum

estrogen levels generally remain within the normal range for postmenopausal

women (44). Given minimal systemic absorption, low doses of vaginal ET

may be an option even for women with a history of estrogen-responsive

cancers or CVD (33,45).

Vaginal use of the hormone dehydroepiandrosterone (DHEA) (0.5% daily)

effectively treats moderate to severe dyspareunia secondary to VVA and is

approved for this indication (46). Circulating levels of estradiol, estrone,

testosterone, and DHEA remain within the normal postmenopausal range.

Endometrial biopsies showed inactive or atrophic uterine lining after one year of

treatment (47).

The estrogen agonist/antagonist, ospemifene (60 mg/day) is an oral agent

approved for the treatment of moderate to severe dyspareunia associated

with VVA (48). Sexual function improves, including reduced sexual pain and

increased arousal and desire (49). Endometrial safety was confirmed at 1 year

(50). As with other estrogen agonist/antagonists, ospemifene may increase the

risk of VTE and vasomotor symptoms, reduces breast density, and has favorable

effects on bone.

Sexual Dysfunction

[8] Sexual problems are highly prevalent, reported in approximately 40% of

US women, with 12% reporting a sexual problem associated with personal

distress (51). Although sexual problems generally increase with aging,

distressing sexual problems peak in midlife women (aged 45 to 64) and are lowest

in women 65 years or older. The etiology of female sexual dysfunction is often

multifactorial, including depression or anxiety, relationship conflict, stress,

fatigue, prior abuse, medications, or physical problems that make sexual

activity uncomfortable, such as endometriosis or GSM. The impact of

menopause per se on sexual function is uncertain (52). Bothersome VMS

causing sleep disruption and fatigue and dyspareunia secondary to GSM are

aspects of the menopause transition that may directly affect sexual desire and

pleasure. Aging, concurrent illness, psychological changes, and relationship and

social factors impact sexual functioning in older women, irrespective of the direct

physiologic and hormonal changes of menopause.

1033ET effectively treats vaginal dryness, dyspareunia, and vasomotor

symptoms, but does not appear to have a direct effect on sexual interest,

arousal, or orgasmic response, independent from its role in treating

menopausal symptoms. In contrast to ET, androgen therapy may improve

sexual function in selected populations of menopausal women (53). The

impact of declining androgen levels with aging and the efficacy of testosterone in

treating female sexual dysfunction remain controversial. Potential risks of

androgen therapy include hirsutism, acne, irreversible deepening of the

voice, and adverse changes in liver function and lipids. As most androgens

are aromatized to estrogens, there is potential for an increased risk of

cardiovascular events and breast cancer. No androgen products are approved

for use in women.

Although VVA and dyspareunia respond well to systemic or local ET, oral

ospemifene, and vaginal DHEA, most other sexual problems may be

effectively treated without hormones. Relationship quality and conflict, stress,

and fatigue predict sexual satisfaction, so couples often benefit from counseling,

lifestyle changes, and sex therapy. Underlying depression and anxiety should be

treated, and antidepressant medication may need adjustment. Bupropion may be

an alternative to an SSRI, or added to SSRI treatment in the setting of FSD.

In women with and without depression, increased sexual arousal and orgasm are

observed with bupropion in small RCTs (54). Sildenafil citrate may benefit

women who develop problems with arousal and orgasmic response on SSRIs,

but generally it is no more effective than placebo for most female sexual

problems (55,56). Even though sexual problems are common, the majority of

women with distressing sexual problems do not seek formal care, but when they

do, it is typically the woman, rather than the physician, who initiates the

conversation (57). Clinicians should routinely ask their menopausal patients

about sexual concerns, as many effective interventions are available (58).

Osteoporosis

[9] Low bone mass and osteoporosis affect an estimated 35 million US

women, or approximately 66% of women older than age 50 years (59).

Because therapy is most likely to benefit those at highest risk, it is important to

review a woman’s risk factors for osteoporosis when making decisions regarding

bone density screening and treatment (Table 18-3). Low bone mass and

osteoporosis are principal risk factors for fractures, which are associated

with an enormous economic cost, pain, disability, and even increased

mortality. Nonmodifiable risk factors include age, race (Asian, Caucasian),

small body frame, early menopause, prior adult fracture, and family history

of osteoporosis. Modifiable risk factors include inadequate intake of calcium

1034and vitamin D, smoking, low body weight, excess alcohol use, and a

sedentary lifestyle. Medical conditions associated with an increased risk of

osteoporosis include anovulation during the reproductive years (e.g.,

secondary to excess exercise or an eating disorder), hyperthyroidism,

hyperparathyroidism, chronic renal disease, rheumatoid arthritis, and

diseases requiring systemic corticosteroid use.

Table 18-3 Risk Factors for Osteoporosis

Nonmodifiable

Age

Race (White, Asian)

Small body frame

Early menopause

Prior adult fracture

Family history of osteoporosis

Modifiable

Inadequate intake of calcium and vitamin D

Smoking

Low body weight

Excess alcohol use

Sedentary lifestyle

Associated Medical Conditions

Anovulation during reproductive years (e.g., due to excessive exercise or disordered

eating)

Hyperthyroidism

Hyperparathyroidism

Chronic renal disease

Rheumatoid arthritis

Conditions requiring systemic corticosteroid use

Bone mineral density (BMD) measurements may be used to determine

fracture risk, diagnose osteoporosis, and identify women who would benefit

from therapeutic interventions. Dual x-ray absorptiometry (DXA) of the hip

and spine is the primary technique for BMD assessment. BMD is reported as

absolute density (grams mineral/cm2) and in relation to two norms. T score is the

standard deviation (SD) above or below the mean for a healthy 30-year-old

woman. Z score is the SD above or below the mean for a woman of similar age.

1035Normal BMD is defined by a T score ê-1, low BMD or osteopenia by a T

score between -1 and -2.5, and osteoporosis by a T score Ä-2.5. Although there

is a strong association between BMD and fracture risk, a woman’s age, risk for

falls, and overall health status significantly influence fracture risk. Evaluation of

BMD by DXA is recommended for all women aged 65 and older, regardless

of risk factors, and for younger postmenopausal women with one or more

risk factors, other than being White and menopausal (60).

Women should be counseled to alter modifiable risk factors as an

important step in the prevention of osteoporosis and fractures (Table 18-4).

Women with diets deficient in calcium and vitamin D will benefit from

dietary modification and supplementation. Daily intake of calcium 1,200 mg

and vitamin D 800 to 1,000 IU is recommended (60). Calcium intake should

be achieved principally through diet. Treatment with calcium and vitamin D

does not appear to directly reduce fracture risk (61). Reducing the risk of

osteoporosis and fractures is another of the many health benefits of regular

weight-bearing and muscle-strengthening exercise, smoking cessation, and

limiting alcohol intake. Other interventions to reduce fracture risk include a home

safety assessment (installing a shower grab bar, carpeting stairs), vision

correction, and avoiding central nervous system depressant medications.

Table 18-4 Recommendations to Reduce Risk of Falls and Fracture

Dietary calcium (1,200 mg/day) with supplementation only if dietary intake insufficient

Vitamin D (800–1,000 IU/day) through diet and/or supplements

Regular weight-bearing and muscle-strengthening exercises

Improve balance

Increase strength

Reduce risk of falls and fractures

Stop smoking

Limit alcohol use

Limit central nervous system depressants

Visual correction, when needed

Home safety assessment

Carpet stairs

Install grab bars in tubs and showers

Night lights

1036Cosman F, de Beur SJ, LeBoff MS, et al; National Osteoporosis Foundation. Clinician’s

guide to prevention and treatment of osteoporosis. Osteoporos Int 2014;25(10): 2359–

2381.

Table 18-5 Options for Osteoporosis Prevention and Treatment

Bisphosphonates

Alendronate (Fosamax) (35 or 70 mg/week orally)

Risedronate (Actonel) (35 mg/week or 150 mg/month orally)

Ibandronate (Boniva) (150 mg/month orally or 3 mg/every 3 months intravenous)

Zoledronic Acid (4 mg every 1 to 2 years intravenous)

Additional potential benefits: none

Potential risks: esophageal ulcers, osteonecrosis of jaw (rare), atypical femoral

fractures (rare) Zoledronic acid: hypocalcemia, atrial fibrillation, renal impairment

Side effects: gastrointestinal distress, arthralgias/myalgias

Hormone Therapy

Estrogen or estrogen/progestin therapy

Additional potential benefits: treatment of vasomotor symptoms and urogenital atrophy

Potential risks: breast cancer, gallbladder disease, venous thromboembolic events,

coronary heart disease, stroke

Side effects: vaginal bleeding, breast tenderness

Tissue-Selective Estrogen Complex

Bazedoxifene (20 mg)/Conjugated estrogens (0.45 mg) (Duavee) (1/day orally)

Additional potential benefits: treatment of vasomotor symptoms and urogenital atrophy

Potential risks: breast cancer, endometrial cancer, gallbladder disease, venous

thromboembolic events, coronary heart disease, stroke

Estrogen Agonist/Antagonist

Raloxifene (Evista) (60 mg/day orally)

1037Additional potential benefits: reduced risk of breast cancer

Potential risks: venous thromboembolic events, stroke

Side effects: vasomotor symptoms, leg cramps

Other

Forteo (Teriparatide) (20 μg/day subcutaneously)

Tymlos (Abzioparatide) (80 μg/day subcutaneously)

Additional potential benefits: none

Potential risks: osteosarcoma (after long-term use in rodents), hypercalcemia

Side effects: musculoskeletal pain

Prolia (Denosumab) (60 mg subcutaneously every 6 months)

Additional potential benefits: none

Potential risks: rash, serious infection, hypocalcemia

Side effects: musculoskeletal pain

Pharmacologic treatment is indicated for all women with osteoporosis (T

score <–2.5), women with a prior hip or vertebral fracture, and women with

low BMD at high fracture risk. FRAX, an online fracture risk assessment

tool, provides the 10-year probability of a major osteoporotic fracture for an

individual woman. FRAX helps to identify women with low BMD (T score

between –1 and –2.5) who will benefit from pharmacologic therapy (62). Prior

to initiating treatment, excluding secondary causes of osteoporosis is advised.

Evaluation may include a comprehensive metabolic panel, complete blood count,

thyroid stimulating hormone level, parathyroid hormone level, 25-OH vitamin D

level, and 24-hour urine collection for calcium.

Drugs used in the prevention and treatment of osteoporosis are principally

antiresorptive agents that reduce bone loss and anabolic drugs that stimulate new

bone formation (Table 18-5). HT effectively prevents and treats osteoporosis

and is FDA approved for osteoporosis prevention. In observational studies,

current ET use, especially if started soon after menopause and continued long

term, reduces osteoporosis-related fractures (63). The WHI trial confirmed a

significant (34%) reduction in hip fractures in healthy women randomized to

HT (CE 0.625 mg per day) after a mean follow-up of 5.6 years (64). Combined

1038with calcium and vitamin D, even very low-dose ET (CE 0.3 mg per day;

transdermal estradiol 0.014 mg per day) produces significant increases in

BMD compared with placebo (65).

The tissue-selective estrogen complex (BZA/CE) is approved for

osteoporosis prevention in postmenopausal women with a uterus (18). The

estrogen agonist/antagonist raloxifene (60 mg orally daily) prevents vertebral

fractures in women with low bone mass and osteoporosis, though does not

appear to reduce the risk of nonvertebral fractures (66). Raloxifene exercises

estrogen-like actions on bone and lipids without stimulating the breast or

endometrium. Raloxifene is approved to reduce the risk of invasive breast cancer

in women at high risk. In an RCT of approximately 10,000 older postmenopausal

women with heart disease or multiple risk factors, raloxifene had no significant

effect on death from any cause, coronary events, or total stroke, though risk of

fatal stroke and venous thromboembolic disease was increased. The risks of

clinical vertebral fractures and invasive breast cancer were significantly reduced

(67).

Bisphosphonates specifically inhibit bone resorption and are very effective

for the prevention and treatment of osteoporosis. Many convenient

formulations are available, including alendronate (35 mg and 70 mg orally

weekly), risedronate (35 mg orally weekly, 150 mg orally monthly),

ibandronate (150 mg orally monthly, 3 mg intravenous every 3 months), and

zoledronic acid (5 mg intravenous every 1 to 2 years) (60). Women should

take oral bisphosphonates on an empty stomach with a large glass of water

and remain upright with nothing else to eat or drink for at least 30 minutes.

Creatinine clearance must be normal. The major side effect is gastrointestinal

distress. Very rare adverse events include esophageal ulceration, osteonecrosis of

the jaw, and atypical femoral fractures. These rare complications are more likely

with high-dose intravenous and long-term bisphosphonate use. As residual

antifracture effects persist for several years after stopping bisphosphonates, it is

reasonable for women to take a “drug holiday” and discontinue treatment after 3

to 5 years, if fracture risk is reduced after initial treatment.

Denosumab (60 mg subcutaneously every 6 months) is a monoclonal

antibody to the receptor activator of nuclear factor-κB ligand. It is approved

for the treatment of postmenopausal osteoporosis and decreases both

vertebral and hip fractures (68). Rare adverse events are similar to those with

bisphosphonates. Unlike most treatments for osteoporosis that inhibit bone

resorption, parathyroid hormone (PTHrP 1–34) (teriparatide 20 lg and

abaloparatide 80 lg subcutaneously daily) stimulates new bone formation,

resulting in significant reductions in vertebral and nonvertebral fractures

(69). Treatment duration typically is 18 to 24 months. Women treated with

1039denosumab, teriparatide, or abaloparatide should initiate an alternative treatment

upon stopping, as rapid bone loss follows discontinuation. Calcitonin nasal spray

(Miacalcin, 200 IU per day intranasal) is an approved, but rarely prescribed

treatment for established osteoporosis.

Cardiovascular Disease

CVD is the leading cause of death for women and 90% of women have one or

more risk factors. Nonmodifiable risk factors include family history and age.

Modifiable risk factors include a sedentary lifestyle, obesity, and smoking.

Medical conditions associated with an increased risk of heart disease include

diabetes, hypertension, and hyperlipidemia. [10] Advising women to alter

modifiable risk factors for CVD and adequately treating diabetes,

hypertension, and hyperlipidemia are important components of the

comprehensive care of midlife women.

Although epidemiologic studies identify an approximately 50% decrease in

coronary heart disease (CHD) in woman who use HT (70), data from RCTs do

not support the use of HT for CHD prevention. Observational studies are prone to

bias, and women who used HT in the past were generally healthier and at lower

risk for CHD than nonusers (71). The WHI randomized, placebo-controlled

trial of combination estrogen–progestin therapy (EPT) showed that rather

than prevent CHD, EPT increased the risk of cardiovascular events in older

women (72). The WHI was a 15-year study sponsored by the National Institutes

of Health to examine ways to prevent heart disease, osteoporosis, and breast and

colorectal cancer in women. There were several different studies in WHI,

involving more than 160,000 healthy postmenopausal women. The WHI clinical

trial enrolled approximately 27,000 women nationwide between the ages of 50

and 79 years. The average age of women in the study was 63 years. The objective

of the WHI RCT was to assess the major health benefits and risks of the most

commonly used HT preparation at the time. Women with a uterus were

randomized to EPT (CE 0.625 mg/MPA 2.5 mg) versus placebo while

hysterectomized women were randomized to ET (CE 0.625 mg) versus placebo.

In the EPT trial, after an average of 5 years of follow-up, risks (hazard ratio

[HR]) were increased for CHD (1.3), breast cancer (1.3), stroke (1.4), and

pulmonary embolism (PE) (2.1), and decreased for hip fracture (0.7) and

colorectal cancer (0.6) (72). The absolute excess risk attributable to EPT was

small, with seven to eight additional CHD events, breast cancers, strokes,

and pulmonary embolisms per 10,000 woman-years. In the ET trial, after an

average follow-up of 7 years, there was no increased risk of heart disease or

breast cancer in estrogen users. Outcomes were similar to those seen in the

EPT WHI trial with respect to venous thromboembolism, stroke, and

1040osteoporotic fractures; there was no effect on colorectal cancer (73).

Further analyses of WHI confirmed that the increased risk of CHD

occurred principally in older women and those who were a number of years

beyond menopause (Table 18-6). No increased risk of CHD was seen in

women between the ages 50 and 59 or within 10 years of menopause (74).

Although stroke was increased with HT regardless of age or years since

menopause, the absolute excess risk of stroke in the younger women was

minimal. These data do not support a role for HT in the prevention of heart

disease, but they do provide reassurance regarding the safety of HT use for

bothersome hot flashes and night sweats in otherwise healthy women under

age 60 or within 10 years of menopause.

Table 18-6 Absolute Excess Risk of Coronary Heart Disease and Mortality with

Hormone Therapy Use in WHI

1041FIGURE 18-1 Women’s Health Initiative hormone therapy trials: absolute risks (cases per

10,000 person-years) for outcomes in the intervention phases of the estrogen–progestin and

estrogen-alone trials by age group. CEE, conjugated equine estrogens; MPA,

medroxyprogesterone acetate. (Redrawn from Kaunitz AM, Manson JE. Management of

menopausal symptoms. Obstet Gynecol 2015;126:859–876. In: Manson JE, Chlebowski

RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the

intervention and extended poststopping phases of the Women’s Health Initiative

randomized trials. JAMA 2013;310(13):1353–1368).

An overview of WHI findings, including both the EPT and ET trials and

postintervention (median 13 years of cumulative follow-up), confirmed that

the absolute risk of adverse events associated with HT use was considerably

lower in younger women (ages 50 to 59 years) than in older women (75). In

this reanalysis, in the intervention phase, a statistically significant increase in

CHD events was no longer seen with EPT use. In both trials, women receiving

HT had a lower risk of vasomotor symptoms, diabetes, and hip fractures and a

higher risk of venous thromboembolism, gallbladder disease, and stroke. Breast

cancer risk was increased in the EPT trial with a reduced risk in the ET trial

observed during the poststopping phase (see Fig. 18-1) (75,76). In an analysis of

mortality with HT use, neither EPT (median 5.6 years) or ET (median use

7.2 years) was associated with risk of all-cause, cancer, or cardiovascular

1042mortality with 18 years of cumulative follow-up (77).

The WHI trials examined treatment only with CEs and medroxyprogesterone

acetate. The effects of other oral estrogen agents, transdermal estradiol, other

progestins, or cyclic HT may be different. In observational studies,

transdermal ET is not associated with an increased risk of venous

thromboembolic disease (78). The average age of women participating in these

trials was more than 15 years beyond the age at which women typically initiate

HT for the treatment of vasomotor symptoms. The “timing hypothesis”

proposes that early initiation of HT, presumably when there is less

atherosclerosis in blood vessels, may result in a more favorable risk–benefit

profile. The findings of the Early Versus Late Intervention Trial With

Estradiol (ELITE) support this hypothesis. HT for 5 years (oral estradiol 1

mg/day with cyclic progesterone vaginal gel in women with a uterus) was

associated with less progression of subclinical atherosclerosis (carotid artery

intima-media thickness [CIMT]) than placebo when initiated within 6 years after

menopause. In contrast, HT had no effect on CIMT when initiated in women

more than 10 years after menopause (79).

Breast Cancer

Breast cancer is a major health concern for menopausal women, as it is the

most common cancer in women and the second leading cause of cancer death

(80). The lifetime risk of invasive breast cancer for US women is 12%; therefore,

any therapies that increase or reduce this risk will have a major impact on

women’s health. [11] Regular screening mammography reduces the risk of

death from breast cancer. The optimal screening interval remains

controversial. It is generally recommended that women at average risk be

offered initiation of screening mammography at age 40, beginning no later

than age 50 years (81). Screening every 1 or 2 years is advised until at least the

age of 75 years. Whether annual or biennial screening is elected should be based

on informed, shared decision making that includes a discussion of benefits and

harms.

Risk factors for breast cancer include age, family history, early menarche, late

menopause, certain genetic carrier states, and prior breast disease, including

epithelial atypia and cancer. Risk is reduced in women who had bilateral

oophorectomy or a term pregnancy before the age of 30. Many of these risk

factors are consistent with the hypothesis that prolonged estrogen exposure

increases breast cancer risk.

Current, long-term use of HT, generally defined as greater than 5 years, is

associated with an increased risk of breast cancer (relative risk [RR] = 1.3) in

observational studies (82). Use of estrogen alone appears to confer a lower risk

1043than combined therapy with estrogen and progestin (83). The WHI randomized

controlled trial demonstrated an increased risk of breast cancer in women

randomized to EPT after approximately 5 years of use (HR = 1.2) (72). The

attributable risk of breast cancer in women randomized to EPT is less than 1

additional case per 1,000 women per year. In contrast, there was no increased

risk of breast cancer with the use of estrogen alone in women with a prior

hysterectomy after an average of 7 years of use (73). HT should not be

prescribed to women with a history of breast cancer and should be used by

women at high risk only after a careful assessment of potential benefits and

risks. A randomized trial of HT use in women with a history of breast cancer and

bothersome hot flashes was stopped after only 2 years, as more new breast

cancers were diagnosed in women randomized to HT (84).

The estrogen agonist/antagonist tamoxifen (20 mg per day orally) is used

in the treatment of estrogen-receptor positive breast cancer. Tamoxifen and

raloxifene reduce the risk of breast cancer in high-risk women by

approximately 50% and are approved for this indication (85). The risk of

venous thromboembolism is increased approximately threefold with the use

of tamoxifen and raloxifene, similar to the increase seen with HT. Tamoxifen

acts as an estrogen agonist in the endometrium, increasing the risk of endometrial

polyps, hyperplasia, and cancer, whereas no endometrial stimulation is seen with

raloxifene. Aromatase inhibitors (AIs) have become the preferred adjuvant

therapy for postmenopausal women with early-stage, hormone receptor–

positive breast cancer (86). Circulating estrogen levels are very low with

associated bone loss, vasomotor symptoms, and GSM.

Dementia

[12] Cognitive decline and dementia are common concerns of menopausal

and aging women. Alzheimer disease is the most common form of dementia

and women are at greater risk for developing the disease than men. The

number of affected individuals in the United States is estimated at over 5

million of which two-thirds are women. Although observational studies suggest

that HT may decrease the risk of Alzheimer disease, this finding has not been

supported by RCTs in older women. The WHI Memory Study (WHIMS) was a

randomized placebo-controlled study of women aged 65 years or older enrolled in

WHI to assess the effect of HT on cognitive function. Women in WHIMS

randomized to EPT experienced a significant twofold increased risk of

probable dementia. The increased risk of dementia seen in women

randomized to estrogen alone was not statistically significant (75). HT should

not be used to prevent or treat dementia. Women should be encouraged to engage

in behaviors that are associated with a lower risk of dementia, including

1044exercising regularly, not smoking, treating underlying hypertension and diabetes,

avoiding head injury, improving hearing, active learning, and staying socially

engaged (87).

HORMONE THERAPY USE

The use of unopposed estrogen is associated with an increased risk of

endometrial hyperplasia and cancer. Therefore, combination EPT is

necessary for all women with a uterus. Treatment may be provided in a

sequential manner, with estrogen daily and progestin for 12 to 14 days of

each month, or in a continuous-combined fashion with estrogen and a lower

dose of progestin daily. Sequential regimens result in regular, predictable vaginal

bleeding. The majority of women using continuous-combined regimens will

experience amenorrhea by the end of 1 year of therapy, but the bleeding that does

occur is irregular and unpredictable. Low-dose combination HT products (e.g.,

CE/MPA 0.45/1.5 and 0.3/1.5 mg per day) generally result in a lower incidence of

breakthrough bleeding and breast tenderness (88).

To reduce overall progestin exposure, women using low doses of oral or

transdermal estrogens may elect off-label intermittent progestin use (e.g., 14 days

every 3 months) (89). A progestin-releasing intrauterine system approved for

contraception in premenopausal women provides endometrial protection in

estrogen-treated menopausal women, although it is not approved for this

indication (90). Increased endometrial surveillance is advised with these

alternative regimens.

There may be additional benefits and reduced risk with nonoral

administration of ET. Systemic delivery of estradiol by skin patch, spray, gel,

or vaginal ring avoids the “first pass hepatic effect” of oral estrogens on

lipids, binding globulins, and clotting factors. Women with thyroid disease do

not require adjustment of thyroid replacement when initiating nonoral ET, as

thyroid globulin levels do not increase. Free testosterone levels do not decline

with nonoral ET, as sex hormone–binding globulin levels are unchanged, which

may be a benefit for women with low libido (91). In a trial of oral versus

transdermal E2 in early menopausal women, transdermal, but not oral ET was

associated with a significant yet moderate improvement in sexual function

compared with placebo (92).

In contrast to oral administration, observational studies do not show an

increased risk of venous thromboembolic events with transdermal estradiol

(78) and possibly a lower risk of stroke (93). Gallbladder disease may not

increase with use of transdermal ET, as with oral (94). Although transdermal

ET does not appear to increase the risk of venous thromboembolic events or

1045gallbladder disease in observational studies, HT remains contraindicated in

women at high risk for venous thromboembolic disease and in those with

active liver or gallbladder disease.

Popularized by the media, many women are interested in using “bioidentical

hormones” for treatment of menopausal symptoms. Bioidentical generally refers

to hormones structurally identical to “natural” hormones made by the ovary,

including estradiol and progesterone. FDA-approved oral and transdermal

estradiol products are available in a wide range of doses, as is an oral form of

micronized progesterone. Progesterone should be taken at bedtime, as it may

cause drowsiness. There is potentially significant increased risk and no known

benefit to the use of custom-compounded “bioidentical” HT formulations,

preparations that are “custom” mixed and packaged by a compounding

pharmacist for an individual patient (95). Women who request natural HT

formulations should be prescribed FDA-approved formulations containing

estradiol and micronized progesterone. All nonoral ET formulations

(transdermal patches, topical spray and gels, and intravaginal ring) contain natural

estradiol (see Table 18-2 for FDA-approved HT formulations).

[5] Contraindications to HT use include known or suspected breast or

endometrial cancer, undiagnosed abnormal genital bleeding, CVD (including

CHD, cerebrovascular disease, and thromboembolic disorders), and active

liver or gallbladder disease. Relative contraindications include high-risk

states for the above disorders. If alternative treatments for bothersome VMS are

ineffective, HT may be appropriate for a woman with a relative contraindication,

following a thorough assessment of potential risks and benefits.

HT is an appropriate option for most healthy woman with bothersome hot

flashes. If she is under age 60 years or within 10 years of menopause, it is

highly likely that benefits will outweigh risks. As with any therapy, HT

should be used at the lowest effective dose for the duration necessary to meet

treatment goals (20,76). The need for continued HT use should be assessed at

least annually. Although HT risks increase with advancing age and duration

of use, long-term use may be appropriate for women with persistent hot

flashes after thorough assessment of benefits and risks and shared decision

making. As HT risks differ depending on formulation, dose, route of

administration, and whether a progestin is needed, treatment should be

individualized based on a woman’s needs and preferences.

SUMMARY

There are many options available to address the health and quality of life concerns

of menopausal women. The primary indication for HT is the alleviation of hot

1046flashes and associated symptoms. Women should be informed of the

potential risks and benefits of all therapeutic options. Care should be

individualized based on a woman’s medical history, needs, and preferences

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