Miriam E. Tucker

October 07, 2014

Washington, DC — The North American Menopause Society (NAMS) will launch the MenoPro iPhone and iPad app at their 25th anniversary meeting, which takes place October 15 to 18 here at the Marriott Gaylord National Hotel.

The meeting will also feature the long-awaited results of the ELITE trial, which assessed hormone therapy in early menopause.

Dr. JoAnn Manson

The app "will revolutionize the management of menopausal symptoms because one of the real barriers is that the decision-making process is so complex," said JoAnn Manson, MD, from Harvard Medical School and Brigham and Women's Hospital in Boston, who is NAMS scientific program chair. "It's cutting-edge science plus highly practical, usable content," she told Medscape Medical News.

It is a decision-support algorithm designed to help clinicians understand treatment options, decide which patients are candidates for the pharmacologic treatment of menopausal symptoms, and guide shared decision-making between the clinician and the patient. It also guides patients through the same process.

It's cutting-edge science plus highly practical, usable content.

"Many clinicians have shied away from prescribing hormone therapy because it's difficult for them to identify appropriate candidates and they're worried they might be prescribing for the wrong patients, who may be at increased risk. This makes it very straightforward, in an algorithm flow-chart sort of way," Dr. Manson explained.

The app contains no advertising, and was developed by NAMS without industry involvement. It will be demonstrated during one of two preconference symposia that will address hot flashes, and will be available for free at the App Store on October 15.

The first preconference symposium is a translational science session cosponsored by NAMS and the National Institute on Aging, entitled The Science of Thermoregulation and Vasomotor Symptoms: New Targets for Research and Treatment.

Dr. Margery Gass

The symposium includes a talk by David Walega, MD, on stellate ganglion blockade for the treatment of vasomotor symptoms, an approach that was found serendipitously during a study of chronic pain, said Margery Gass, MD, from the Cleveland Clinic and Case Western Reserve University, who is the executive director of NAMS.

"You give an injection into the neck around the stellate ganglion and it markedly reduces hot flashes," she told Medscape Medical News. "It has been done so far in small trials. People are looking into making it a treatment option."

The second premeeting symposium, entitled Hot Flashes — The Hallmark of Menopause: Personalizing Treatment in 2014, will examine the latest information on causes, the impact on sleep and mood, conventional and novel hormonal therapy, nonhormonal pharmacologic and nonpharmacologic options, and tailoring treatment to the individual patient.

ELITE Trial Results

Among the notable research findings to be presented is the Early vs Late Intervention Trial With Estradiol (ELITE), which will provide the first-ever answer to the question of whether giving hormone therapy early in menopause prevents cognitive decline, Dr. Gass told Medscape Medical News.

"This is a long-awaited trial result," she said. "There has been recent debate about whether results would be markedly different if women started hormones early in menopause, rather than starting them late in life. There might be a beneficial effect in preserving cognitive function while you're younger, or preventing cognitive decline and dementia later."

Several posters will provide information on the increasing and controversial use of compounded bioidentical hormone therapy, which is not approved by the US Food and Drug Administration and is often marketed with misinformation.

"The problem is that these types of combinations and preparations have not been tested," Dr. Gass explained. "There's a double standard; some drugs have to be tested and monitored carefully, but here is quite a large industry that is not being monitored or tested at all. The advertising is that these are natural and bioidentical when, in fact, they're made like any other hormones — in a lab," she pointed out.

First-Time Plenary

A session theme, debuting at the meeting, is how to recognize and manage patient's concerns about skin and hair. This will feature sessions on benign and potentially dangerous aging skin lesions and excessive and thinning hair. Speakers will include top dermatologic experts, Dr. Manson told Medscape Medical News.

"I think this will be tremendously valuable to clinicians. Skin and hair disorders are really undertreated and underaddressed," she said. "We're trying to empower the clinician to address these issues, which are important concerns of patients."

Other notable plenary topics, Dr. Manson reported, include breast cancer, osteoporosis, pelvic floor dysfunction, thyroid disorders, mid-life weight gain, heart failure and atrial fibrillation, and a woman-focused discussion of the controversial new guidelines on cardiovascular risk and hypertension.

Dr. Manson told Medscape Medical News that she's particularly looking forward to celebrating the 25th anniversary of NAMS with colleagues from around the world. "Our first meeting was in 1989. It's going to be an exciting meeting and celebration of NAMS' history, and a look to the future."


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