From the Research
Recommended Duration of Therapy for Estradiol (Hormone Replacement Therapy) Patch
The recommended duration of therapy for Estradiol (Hormone Replacement Therapy) patch in Menopausal Hormone Therapy (MHT) is a topic of ongoing debate.
- The risk of breast cancer is higher with estro-progestogen combinations than with estrogens alone, and the preferential use of progesterone or dihydrogesterone may limit the excess risk of breast cancer associated with MHT, at least for durations of treatment of less than 5 to 7 years 1.
- It is recommended that HRT should not be used for treatment durations of more than five years, and treatment should be discontinued in women at risk of complications 2.
- The timing of HT initiation and duration may be important factors to consider when prescribing HT, especially in women with adverse cardiometabolic profile and pre-existing conditions such as coronary/carotid atherosclerosis 3.
- When HT is initiated >10 years since the menopause onset (>60 years old), due to greater absolute risks of coronary heart disease, stroke, and venous thromboembolism, HT should be used for the shortest time possible and in the lowest possible dose, and preferably transdermal administration should be recommended 3.
- Recent studies suggest MHT safety in younger women, women within 10 years of menopause, and women who use low-dose MHT for short durations for menopause symptom relief 4.
Factors Influencing Duration of Therapy
Several factors influence the recommended duration of therapy, including:
- Individual risk of breast cancer, coronary heart disease, venous thromboembolism, and stroke 2.
- Benefit-risk balance, which must be evaluated regularly 1.
- Evolution of symptoms when MHT is stopped, as well as menopause-related health risks or induced by MHT 1.
- Baseline CVD risk assessment, which should be applied when prescribing HT 3.