Hormone Therapy for Menopausal Women in the Primary Care Setting

Kyleen E. Swords, MS, FNP-BC


Journal for Nurse Practitioners. 2017;13(8):562-569. 

In This Article

Abstract and Introduction


Menopausal hormone therapy (MHT) is the most effective treatment for vasomotor symptoms; however, many women receive inadequate treatment because of a misunderstanding of important MHT research. Reanalysis of findings from the Women's Health Initiative, in conjunction with recent findings from the Study of Women Across the Nation and the Kronos Early Estrogen Prevention Study, support the use of MHT in women who are < 10 years from the onset of menopause and are free of contraindications. Primary care providers are in the ideal position to provide evidence-based counseling to patients and help women make an individualized decision to use MHT safely.


Menopause is a universal and normal, physiologic progression in a woman's life. By the year 2020, it is estimated that over 50 million women in the United States will be in the perimenopausal/menopausal transition period;[1,2] approximately 75% of these women will experience vasomotor symptoms (VMSs) affecting their quality of life.[1,3,4] Although menopausal hormone treatment (MHT) is considered the most effective therapeutic option for the treatment of these symptoms,[1,4–6] many women with moderate to severe VMSs receive inadequate treatment with nonhormonal methods or no treatment at all because of safety concerns related to MHT.[1,7] A recent study published in the New England Journal of Medicine noted that education for the treatment of menopausal symptoms is lacking in the standard curriculum for both obstetriciangynecologists and primary care providers.[1] The lack of standardized curriculum, as well as a widespread misunderstanding of important MHT research studies, has contributed to the increased number of untreated women suffering from VMSs.[1,2,8,9] Nurse practitioners (NPs) in primary care are in the ideal position to close this gap and provide evidence-based counseling and treatment during this phase of life.[6]