Interactive Session - Hormone Therapy in Early Menopause
Time:1:15 pm - 2:15 pm
Location:Room 7 - San Diego Convention Center
Lubna Pal, M.B.B.S., M.Sc. (Chair), Yale University
Hugh S. Taylor, M.D., Yale University
Nanette F. Santoro, M.D., University of Colorado Denver
Hormone Therapy in Early Menopause
Needs Assessment and Description
Kronos Early Estrogen Prevention Study (KEEPS) is a
multicenter, randomized, controlled trial of menopausal
hormone therapy (MHT) that was designed to tackle headon
the timing hypothesis. The primary goal of KEEPS was
to assess cardiovascular implications of estrogen when
initiated early in the process of menopause in otherwise
healthy women within 3 years of their last menstrual period.
The neurocognitive ancillary study to KEEPS focused on the
study of effects of menopausal hormones on neurocognitive
parameters in early postmenopausal women. KEEPS
investigators will share the observed effects of menopausal
hormones on cardiovascular and neurocognitive endpoints
in participants who completed a 4-year randomized,
controlled trial of estrogen (0.45 mg of conjugated equine
estrogens, 50 mg weekly transdermal estradiol) both in
combination with cyclic oral, micronized progesterone (200
mg for 12 days each month) and placebo. This live course
for womens' healthcare providers and trainees will offer
a critical update of evidence and will provide evidencebased
recommendations for optimizing care for early
At the conclusion of this session, participants should be able
- Describe the implications of menopausal hormone use for
cardiovascular endpoints in early menopausal women.
- Explain effects of menopausal hormones on cognitive
parameters and mood in early menopausal women.
- Discuss risk versus benefit of menopausal hormone
therapy in early menopausal women.
A 50-year-old Caucasian woman presents for consultation
for bothersome vasomotor symptoms, disturbed sleep and
increasing forgetfulness. Her last menstrual period was 13
months prior to this visit. Her medical history is unremarkable.
Her family history is significant for hypertension (mother
became hypertensive at age 55) and for dementia
(maternal grandmother was diagnosed with dementia at
age 70). After participating in this session, in my practice I
will counsel this patient:
- Regarding risks versus benefits of menopausal hormone
therapy, especially cardiovascular and neurocognitive
- That hormone therapy should be avoided.
- That she should consider undergoing hysterectomy.
- Not applicable to my area of practice.