Monday, 3 March 2014


Evidence Based Reports

Acupuncture for menopausal hot flushes. (2013) [Cochrane Library] NEW

Ospemifene for vulvo-vaginal atrophy in postmenopausal women. (2013) [HTA] NEW

Short and long term effects of tibolone in postmenopausal women. (2012) [Cochrane Library] NEW

Hormone therapy in postmenopausal women and risk of endometrial hyperplasia. (2012) [Cochrane Library] NEW

Cost effectiveness of secondary vs tertiary prevention for post-menopausal osteoporosis. (2012) [NHS EED] NEW

Black cohosh (Cimicifuga spp.) for menopausal symptoms. (2012) [Cochrane Library] NEW

Long term hormone therapy for perimenopausal and postmenopausal women (2012) [Cochrane Library] NEW

Short and long term effects of tibolone in postmenopausal women. (2012) [Cochrane Library] NEW

Adjuvant gonadotropin-releasing hormone analogues for the prevention of chemotherapy induced premature ovarian failure in premenopausal women (2011)[Cochrane Library]

Timing of breast surgery in premenopausal breast cancer patients (2011)[Cochrane Library]

Exercise for vasomotor menopausal symptoms (2010)[Cochrane Library]

Menopausal hormone therapy and risk of lung cancer: systematic review and meta-analysis (2010)[DARE]

Efficacy of black cohosh-containing preparations on menopausal symptoms: a meta-analysis (2010)[DARE]

Hormone therapy for endometriosis and surgical menopause (2009)[Cochrane Library]

Cost-effectiveness of hormone replacement therapy for menopausal symptoms in the UK (2009)[NHS Economic Evaluation Database]

Trifolium pratense isoflavones in the treatment of menopausal hot flushes: a systematic review and meta-analysis (2008)[DARE]

Clinical Guidelines

Menopause (2008)[CKS] updated

Alternatives to HRT for the Management of Symptoms of the Menopause. (2010)[RCOG]

Recent articles in core journals

Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. (2013) [JAMA] NEW

Denosumab Compared With Ibandronate in Postmenopausal Women Previously Treated With Bisphosphonate Therapy: A Randomized Open-Label Trial. (2013) [EvidenceUpdates] NEW

Effect of diet and exercise, alone or combined, on weight and body composition in overweight-to-obese postmenopausal women. (2013) [EvidenceUpdates] NEW

Effect of hormone replacement therapy on cardiovascular events in recently postmenopausal women: randomised trial. (2012) [BMJ] NEW

Paced Respiration for Vasomotor and Other Menopausal Symptoms: A Randomized, Controlled Trial. (2012) [EvidenceUpdates] NEW

Health symptoms during midlife in relation to menopausal transition: British prospective cohort study. (2012) [BMJ] NEW

Effect of 12 months of whole-body vibration therapy on bone density and structure in postmenopausal women: a randomized trial.(2011)[Annals of Internal Medicine]

Efficacy of escitalopram for hot flashes in healthy menopausal women: a randomized controlled trial.(2011)[JAMA]

Benefits and risks of postmenopausal hormone therapy when it is initiated soon after menopause (2009)[EvidenceUpdates]

Desvenlafaxine for the treatment of vasomotor symptoms associated with menopause: a double-blind, randomized, placebo-controlled trial of efficacy and safety (2009)[EvidenceUpdates]

Revisiting the duration of vasomotor symptoms of menopause: a meta-analysis (2009)[EvidenceUpdates]

Increased risk of parkinsonism in women who underwent oophorectomy before menopause. (2008)[EvidenceUpdates]

Menopause. (2008)[Lancet]


Menopause and its Management (2013)[Mentor]UPDATED

Menopause andMood Disorders (2012)[eMedicine] updated

Menopause (2011)[eMedicine]

Clinical Queries

How long can we safely use topical HRT e.g.vagifem for atrophic vaginitis in postmenopausal women? (2013) [ATTRACT] NEW

I am looking after a 44yr old woman with recurrent DVT and who is on life-long Warfarin. She is menopausal with debilitating hot flushes. What is the evidence with regards to use of HRT or antidepressant therapy respectively in such a patient? (2013) [ATTRACT] NEW

Is it appropriate to leave a levonorgestrel releasing intrauterine system (LNG-IUS) in a woman indefinitely past the menopause? (2013) [FSRH] NEW

How long can we safely use topical HRT e.g.vagifem for atrophic vaginitis in postmenopausal women? (2013) [ATTRACT] NEW

is there any evidence to advise on dose of clonidine beneficial for menopausal flushes?I have a patient who feels that 75mcg works for her and 25mcg doesnt.what does evidence support? (2012) [TRIPanwers] NEW

How reliable is a single raised FSH and LH levels in diagnosing menopause in women age 46? (2012) [TRIPanswers] NEW

What is the risk of osteonecrosis of the jaw for a post-menopausal woman taking a bisphosphonate for osteoporosis? (2012) [TRIPanswers] NEW

Do patients who are needing oestrogen for relief of menopausal symptoms need progesterone also if they have a mirena coil in situ,or is this sufficient to provide the progesterone component? If the latter, for how long from time of insertion? (2011)[TripAnswers]

What would the advice be re. stopping microgynon in 50 yr old woman (who has been taking this for 32 yrs) - would changing to Mirena coil + watchful waiting for menopausal symtoms be best option? Addition of HRT if needed for symptom relief? (2011)[ATTRACT]

Should a 38 year women who has had a hysterectomy continue with HRT until normal menopause age (50) or stop sooner than this? No family history of breast cancer etc. (2010)[ATTRACT]

Is HRT recommended for a patient on goserelin for endometriosis experiencing menopausal symptoms? (2009)[ATTRACT]

What is an normal endometrial thickness and is it different during the menopause?

Patient Information

Menopause and HRT(2013)[Patient UK] UPDATED

Menopause (inc HRT)(2013)[BUPA] UPDATED

Menopause (2012)[NHS Choices] UPDATED


1. If you are a Welsh Primary Care Professional with a clinical query send it to ATTRACT online or email us at or call 01495 332343.
2. If you would like to comment on this CME topic, or suggest a new topic for ATTRACTcme, go to the comments hyperlink below.

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