What is the role of estrogen therapy in the treatment of the vasomotor symptoms of menopause?

Updated: Oct 16, 2018
  • Author: Janice L Bacon, MD; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Answer

Answer

As previously mentioned, estrogen therapy, with or without a progestogen, has long been prescribed to treat menopausal symptoms and is the most consistently effective therapy for vasomotor symptoms. [1] Numerous studies suggest that oral, transdermal, or vaginal hormone therapy reduce the severity of hot flashes by 65-90%. [2, 3, 4, 5, 6, 7, 8, 9, 10]

In a review by Prior, oral micronized progesterone (OMP) appears to effectively treats vasomotor symptoms and sleep disturbances, and monotherapy (300 mg each night) is potentially safe for symptomatic menopause. [22, 113]

For women with an intact uterus, estrogen should be combined with a progestogen or with bazedoxifene (selective estrogen receptor modulator) to prevent the unopposed adverse effects of estrogen alone on the endometrium.


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