New ACOG Guidelines Revamp Menopause Treatment Options

POLICY WIRE — Washington, DC — The American College of Obstetricians and Gynecologists (ACOG) has unveiled updated clinical guidelines for managing menopause symptoms, the first update in 12 years. The new recommendations emphasize the effectiveness of hormone therapy and a range of non-hormonal treatments.

The revised guidelines come as the FDA has removed a long-standing boxed warning from hormone-based menopause treatments, sparking renewed interest and demand. According to Dr. Camille Clare, president of ACOG, ‘We encourage patients to consult their OB-GYNs about menopause and advocate for the treatment they need.’

Menopause, which typically occurs around age 50, brings a range of symptoms such as hot flashes, night sweats, and sleep disturbances. ACOG reports that more than half of menopausal women experience these ‘vasomotor’ symptoms, while up to two-thirds report sleep issues. Over a third of perimenopausal and postmenopausal women worldwide also experience depressive symptoms.

Dr. JoAnn Manson, a professor at Harvard Medical School, notes a growing consensus that these symptoms should be treated. ‘Moderate to severe menopausal symptoms should be addressed with hormone therapy as the first line of treatment,’ she said, adding that while not all women are candidates, many can benefit.

The FDA’s removal of the boxed warning last year has helped to revitalize interest in hormone treatments. However, some women have reported difficulties in obtaining certain estrogen patches. FDA officials stated that they are unaware of an imminent national shortage and that manufacturers have doubled their production to meet demand.

ACOG’s guidelines detail various hormone therapy options, including whole-body therapies like pills, patches, and vaginal rings, as well as low-dose vaginal estrogen for localized symptoms. The organization recommends that decisions about hormone therapy should be made jointly by doctors and patients, considering individual benefits and risks.

For those who cannot or choose not to use hormone therapy, ACOG suggests alternatives such as fezolinetant and elinzanetant, which target the brain’s temperature regulation and can alleviate hot flashes. Antidepressants and non-drug treatments like cognitive behavioral therapy, mindfulness, and acupuncture are also endorsed.

Dr. Stephanie Faubion, medical director at The Menopause Society, emphasized the importance of the new ACOG guidelines. ‘Hormone therapy is the most effective treatment for hot flashes, and women have a variety of options to manage their symptoms,’ she said.

Dr. Clare urged women to seek reliable information from their healthcare providers, warning against misinformation found online. ACOG provides resources to help patients navigate the truth about menopause treatments.

Reporting by Policy-Wire (PW)