NICE’s updated guideline on menopause, published today (November 7), emphasises the importance of a personalised, tailored approach when considering the options for managing related symptoms.  

The guideline recommends HRT for vasomotor symptoms such as hot flushes and night sweats. It also advises prescribers to tailor information about its benefits and risks based on age, individual circumstances and any potential risk factors. 

It also recommends that for women over 40 years of age, healthcare professionals should consider menopause-specific cognitive behavioural therapy as an option for vasomotor symptoms in addition to HRT. This approach can also be taken for people for whom HRT is not advised, or for those who prefer not to take HRT. 

NICE has also published a discussion aid for healthcare professionals for conversations on HRT, which focuses on the incidence of key health outcomes with and without HRT.  

The guideline highlights that while there are some increased risks associated with taking HRT, it is unlikely to increase or decrease overall life expectancy. 

Professor Jonathan Benger, chief medical officer and interim director of the centre for guidelines at NICE, said: “Recognition of the impact that menopause symptoms can have has grown in recent years, but we know that there remains more to be done to improve the consistency and quality of support – not least for women from minority ethnic backgrounds or from a poorer area, who are often unaware of or unable to access treatments that could help them.” 

The updated guideline also includes new recommendations on the management of genitourinary symptoms such as vaginal dryness, painful sex and vaginal discomfort or irritation. A choice of vaginal oestrogen such as cream, gel, tablet, pessary or ring should be offered.