After Surgical Menopause, Should Menopausal Hormonal Therapy Started Only Before the Age of 45 Years?

Kitirat Techatraisak

doi:10.33696/gynaecology.2.017

Abstract

The published study Compliance and health consequences of menopausal hormonal therapy after surgical menopause: A retrospective study in Thailand showed that menopausal hormonal therapy soon after bilateral oophorectomy before the age of natural menopause in Thailand possibly prevented subsequent osteopenia compared with menopausal hormonal therapy non-users, also without significant adverse breast outcomes comparing between hormonal therapy users and non-users. According to that study, additional data showed that the number of early hormonal users (initiated before age 45 years) who continued hormonal therapy until at least 50 years old (average natural menopausal age in Thailand) is less than that of late hormonal users (initiated at age ?45 years). Therefore, hormonal replacement therapy after bilateral oophorectomy before the age of natural menopause, in the absence of contraindication, should be commenced soon at any age after surgery and maintained until at least the age of natural menopause to prevent possible long-term adverse health outcomes from early estrogen deprivation.

Highlights

Natural menopause occurs at different ages in different countries ranging from as young as 46.9-47.8 years in the Middle-East region to 50.0-51.1 years in the European countries [1], and previously reported at the approximate age of 50 years in Thailand [2]
The results showed that 85.5% of the patients used menopausal hormonal therapy (MHT) after surgery
The additional data presented in this article raised awareness for initiating MHT in women at the age ≥45 years at the time of surgical menopause

Summary

Introduction

Natural menopause occurs at different ages in different countries ranging from as young as 46.9-47.8 years in the Middle-East region to 50.0-51.1 years in the European countries [1], and previously reported at the approximate age of 50 years in Thailand [2]. Many previous observational studies and randomized clinical trials showed that early menopause, especially bilateral oophorectomy before menopause, was associated with an increased risk of ischemic heart disease [19].

Results

Conclusion