Title: Premature Menopause
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British Menopause Society Council Consensus Statement
Summary
The British Menopause Society Council aims to aid health professionals to inform and advise women about the menopause. There has been some confusion among women and health professionals since the publication of the Women’s Health Initiative and Million Women studies about the management of premature ovarian failure (POF). Both studies were undertaken in women aged 50 and over, and cannot be extrapolated to their younger counterparts, who would normally be producing their endogenous estrogen, since they have functioning ovaries. Estrogen-based replacement therapy is the mainstay of treatment for women with POF and is recommended at least until the average age of natural menopause (52 years in the UK). This view is endorsed by regulatory bodies such as the Committee on Safety of Medicines (now the Commission on Human Medicines) in the UK. No evidence shows that estrogen replacement increases the risk of breast cancer to a level greater than that found in normally menstruating women, and women with POF do not need to start mammographic screening early unless other risk factors are present, such as family history.
5 June 2007
Summary practice points
- Women with a premature menopause should normally be offered HRT until the average age of the menopause (52 years)
- Hormone replacement therapy or the combined estrogen and progestogen contraceptive pill may be used
- Women with POF who take HRT may need a higher dose of estrogen to control vasomotor symptoms than women in their 50s
- Consideration should be given to additional treatment with testosterone, especially in oophorectomized women
- Women with karyotypically normal POF may conceive naturally
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