Guidelines for menopausal hormone therapy: Recommendations of the Polish Menopause and Andropause Society – state of knowledge as of December 2013

Having thoroughly reviewed the literature on this topic, Members of the Management of the Polish Menopause and Andropause Society present up-to-date recommendations concerning menopausal hormone therapy (MHT).



Menopausal hormone therapy should be regarded as an important element of health care provided to peri- and postmenopausal women with a view to improving their quality of life and preventing adverse consequences of chronic estrogen deficiency.

Menopausal hormone therapy should be a part of health-promotion activities encompassing: prophylactic check-ups in order to detect risks and prevent the development of the most common age-related diseases or treat them at an early stage; recommendations regarding healthy diet and physical activity to maintain proper body weight with a concurrent emphasis on quitting smoking and reducing alcohol intake.

All women should be ensured access to reliable information on benefits and risks associated with MHT based on the assessment of their current health status, family and personal medical history, and potential risk of the development of chronic diseases and cancer.

The second half of the 20th century saw a rapid growth in the frequency of MHT prescription. The publication of results obtained in the HERS trial (1998) [1], followed by the initial results of the WHI trial (2002) [2], undermined the fundamental assumptions of MHT as a method of primary and secondary prevention of chronic diseases. Subsequent years saw the publication of a number of detailed assessments taking into account women’s age, time from the last menstrual period until the commencement of therapy, effects of MHT on different body organs and systems, treatment regimens, types and doses of hormones, route of administration and duration of therapy [3, 4]. Interpretations of fragmentary results of observational studies and WHI trials were often mutually contradictory, resulting in informational chaos and diverse approaches to MHT applied by physicians of different specialties. The first international consensus reached on the basis of opinions submitted by endocrinologists, gynecologists and cardiologists was the official position announced by the Polish Gynecology Society, Polish Cardiac Society and Polish Menopause and Andropause Society in 2007 [5].

During the past four years, there were attempts to systematize available knowledge, resulting in a number of...


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