Feature Article

Managing menopause after the Women’s Health Initiative study

Terri Foran



The findings of the Women’s Health Initiative study profoundly affected patient and clinician perceptions of the role of hormone therapy in the management of menopause. This article reviews the options for women with menopausal symptoms.

Key Points

  • The promotion of a healthy lifestyle and reduction of risk factors for heart disease and osteoporosis form an integral part of an overall approach to menopause management.
  • Hormone therapy remains the most effective way of managing vasomotor symptoms such as hot flushes, and there is no evidence that the use of combined hormone therapy for less than five years is associated with an increased risk of breast cancer.
  • There are few risks associated with the use of topical vaginal oestrogen, and its more widespread use has the potential to reduce many of the urogenital symptoms common in older women.
  • There is now a range of therapies available for the management of osteoporosis; these should be tailored to the particular needs of the woman seeking treatment.
  • Although many women regard complementary therapies as safer alternatives to conventional medical treatments, there is conflicting evidence for their effectiveness and long term safety.