The American College of Obstetricians and Gynecologists (ACOG) has issued new clinical guidance regarding the use of hormone therapy for common menopause and perimenopause symptoms. The recommendations endorse hormone therapy for managing vasomotor symptoms, which include hot flashes, night sweats, and sleep disturbances.
This update represents the first time in more than a decade that ACOG, a professional organization for obstetricians and gynecologists in the United States, has revised its advice on hormone therapy. Dr. Kameelah Phillips, an OB-GYN and menopause specialist, stated that hormone replacement therapy is now considered a first-line treatment for these symptoms, shifting away from previous common recommendations of antidepressants or lifestyle changes.
Menopause symptoms generally occur due to declines in estrogen and progesterone, typically when a woman is in her late 40s or early 50s. ACOG noted that while menopause is a natural stage of life, patients should not have to manage symptoms without medical assistance. Hormone therapy can be administered via pills, patches, sprays, gels, or vaginal rings.
The guidance outlines specific eligibility criteria, noting that hormone therapy should generally begin before age 60 or within 10 years of the start of menopause. ACOG advises that individuals with a history of blood clots, stroke, liver disease, or breast cancer should avoid these therapies. Dr. Céline Gounder, a CBS News medical contributor, noted that while a 2002 study raised concerns about breast cancer risks, newer research suggests that treatment is safe for many patients when age and dosing are considered.
The change for patients will be observed in clinical consultations. Those who qualify for hormone therapy will need to undergo screening for contraindications, such as history of stroke or liver disease, to determine eligibility. ACOG notes that for those who are ineligible for hormones, non-hormonal medical options remain available.
The shift in recommendations may also influence how bone health is managed, as low hormone levels are linked to reduced bone density and higher risks of osteoporosis. Patients experiencing symptoms can seek these updated treatment options through their healthcare providers.