Menopause Hormone Therapy (MHT) is the treatment for the management of moderate to severe menopause symptoms and is low risk in women between 50-60 years or within 10 years of the final menstrual period
Transdermal oestradiol and oral micronized progesterone is considered to have lower risks of all the available therapies.
Treatment of vasomotor symptoms in women with a history of breast cancer can be challenging. Antidepressants such as venlafaxine, paroxetine and escitalopram have been used as well as gabapentin and clonidine. Recent studies suggest that hypnotherapy and cognitive behavioural therapy have also been successful. Vaginal oestrogens for urogenital atrophy are used but in those women on aromatase inhibitors it is controversial.
The newest product available is a TSEC therapy, a combination of conjugated oestrogens and a SERM, bazedoxifene.
Why women have hot flushes is still a puzzle but further neurochemistry findings suggest a new research pathway for treatment.