The 2017 Hormone Therapy Position Statement of The North American Menopause Society

The North American Menopause Society 2017 Hormone Therapy Position Statement Advisory Panel

Disclosures

The North American Menopause Society (NAMS). 2018;24(7):728-753. 

In This Article

Endometrial Cancer

Unopposed systemic ET in postmenopausal women with an intact uterus increases the risk of endometrial cancer, which is dose and duration related. More risk is seen earlier with higher doses and persisting for several years after discontinuation.[8] Adequate concomitant progestogen is recommended for women with an intact uterus when using systemic ET.

After Endometrial Cancer

Current data, including a meta-analysis based largely on retrospective studies with one RCT, suggest that recurrence and death rates are similar for women who have been treated for early stage, low-risk endometrial cancers (grade 1 and grade 2 endometrioid subtypes with negative estrogen and progesterone receptors) if HT is used.[234–239] However, ET is not recommended for those with more advanced stages or higher risk endometrial cancer.[234,240–244]

Key Points

  • Use of HT may be considered in symptomatic women with surgically treated, early stage endometrial cancer (low risk) if other options are not effective, particularly in women with early surgical menopause who are at higher risk of health consequences related to estrogen loss.

  • Nonhormone therapies are recommended for women higher-risk endometrial with more advanced cancer or cancer.

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