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Minerva Ginecologica 2017 April;69(2):160-70

DOI: 10.23736/S0026-4784.16.04007-7

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

New options for menopausal symptoms after 15 years of WHI Study

Santiago PALACIOS 1, Pluvio J. CORONADO 2

1 Director of Instituto Palacios, Madrid, Spain; 2 Department of Obstetrics and Gynecology, San Carlos Clinic Hospital, Madrid, Spain


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Menopausal symptoms include vasomotor symptoms (VMS), vulvar-vaginal atrophy, and loss of bone mass associated with an increased risk of fracture. Treatment of VMS consists of lifestyle changes, hormone treatment (estrogens with and without progestogens, tissue selective estrogens complex or conjugated estrogens and bazedoxifene [CE/BZA], progestogens, and tibolone), and nonhormonal treatments. Genitourinary symptoms due to vulvar-vaginal atrophy are treated with systemic and local hormones, moisturizer creams and gels, CE/BZA, and a selective estrogen receptor modulator (ospemifene). In addition to lifestyle changes, treatments for the risk of fragility fracture include calcium and vitamin D, hormone treatment, selective estrogen receptor modulators (raloxifene, BZA), bisphosphonates, strontium ranelate, denosumab, and teriparatide. This article reviews treatment options and provides treatment algorithms for women with menopausal symptoms.


KEY WORDS: Vulva - Atrophy - Fractures, bone - Risk - Therapeutics - Menopause

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