American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the diagnosis and treatment of menopause

Menopause is strictly defined as 1 year without menses. In fact, however, the ovaries progressively fail to produce estrogen. This failure often begins in the late 30s, and most women experience near-complete loss of production of estrogen by their mid-50s. Menopausal hormone therapy (MHT) is the most effective intervention for management of these symptoms that diminish the quality of life. The goal of MHT, defined as estrogen therapy alone or a combination of estrogen and a progestational agent, is to alleviate the quality-of-life symptoms in menopausal and perimenopausal women. This consensus document will present recommendations for the use of MHT for the relief of menopausal symptoms. It will consider the possible role of MHT in the prevention of chronic disorders associated with estrogen deficiency. For women who cannot or do not wish to use estrogen for control of severe vasomotor symptoms, lifestyle changes should be implemented first. If pharmacologic therapy is needed, the most effective nonestrogen class of agents is the antidepressants.