9
Breast Cancer
Î For women considering MHT for menopausal symptom relief, ES
suggests evaluating the baseline risk of breast cancer and taking
this risk into consideration when advising for or against MHT and
when selecting type, dose, and route of administration. (2|⊕⊕
)
Î For women at high or intermediate risk of breast cancer
considering MHT for menopausal symptom relief, ES suggests
nonhormonal therapies over MHT to alleviate bothersome VMS.
(2|⊕⊕
)
Tailoring MHT
Î ES suggests a shared decision-making approach to decide
about the choice of formulation, starting dose, the route of
administration of MHT, and how to tailor MHT to each woman's
individual situation, risks, and treatment goals. (US)
Custom-Compounded Hormones
Î ES recommends using MHT preparations approved by the US Food
and Drug Administration (FDA) and comparable regulating bodies
outside the United States and recommend against the use of
custom-compounded hormones. (US)
Conjugated Equine Estrogens with Bazedoxifene
Î For symptomatic postmenopausal women with a uterus and
without contraindications, ES suggests the combination of
conjugated equine estrogens (CEE)/bazedoxifene (BZA) (where
available) as an option for relief of VMS and prevention of bone
loss. (2|⊕⊕⊕
)
Tibolone
Î For women with bothersome VMS and climacteric symptoms and
without contraindications, ES suggests tibolone (in countries
where available) as an alternative to MHT. (2|⊕⊕
)
Î ES recommends against adding tibolone to other forms of MHT.
(1|⊕⊕
)
Î ES recommends against using tibolone in women with a history of
breast cancer. (1|⊕⊕
)
