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Clinical guidance

NICE to offer guidance on management of menopausal symptoms

The National Institute for Health and Care Excellence (NICE) has for the first time produced guidelines for the diagnosis and treatment of menopause

Source: BSIP SA / Alamy

The risks and benefits of hormone replacement therapy must be fully discussed with women experiencing menopausal symptoms, says draft NICE guidance

The National Institute for Health and Care Excellence (NICE) has for the first time produced guidelines for the diagnosis and treatment of menopause.

The draft proposals, out for consultation until 13 July 2015, are designed to help the 80% of women in the UK who experience menopausal symptoms, which last for an average of four years. For 10% of women, the effects of the menopause can continue for up to 12 years.

Launching the document, Mark Baker, director of the centre for clinical practice at NICE, said the effects of the menopause are often misunderstood and underestimated, pointing out that symptoms range from hot flushes and joint stiffness to brittle bones and cardiovascular disease.

The draft guideline says women should be clear about the short and long-term effects of taking hormone replacement therapy (HRT) and that its risks and benefits should be fully discussed. It recommends HRT is offered as treatment for vasomotor symptoms (hot flushes and night sweats). HRT or cognitive behavioural therapy is recommended for the treatment of mood swings. If HRT is contraindicated then alternatives include acupuncture and hypnosis, the draft guideline proposes.

The guidance highlights the potential risks of alternative treatments, such as black cohosh or isoflavones, pointing out that their safety is unknown.

Recommendations about lifestyle changes to help alleviate some of the symptoms should also be discussed.

The final NICE guideline is due to be published in October 2015.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2015.20068648

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