American College of Obstetricians & Gynecologists issues updated guidance on menopause symptoms and treatments

Patients and healthcare providers navigating menopause management receive updated clinical recommendations on hormone and nonhormonal options, alongside federal updates regarding the availability and labeling of treatments.

• •The American College of Obstetricians & Gynecologists (ACOG) released its first updated guidance on managing menopause symptoms in 12 years.
• •ACOG recommends hormone therapy as the first line of treatment for moderate to severe or bothersome menopausal symptoms for many women.
• •The FDA announced it would remove boxed safety warnings from more than 20 hormone-based pills, patches, and creams, and approved updated labeling for three additional estrogen-based patches.
• •Drug manufacturers have doubled their output of hormone-based products over the last year by adding manufacturing shifts and production capacity.
• •FDA officials stated they are unaware of an imminent risk of a nationwide shortage of estrogen patches despite reports of difficulty obtaining certain doses.
• •ACOG advises that hormone therapy decisions should be made jointly by doctors and patients, preferably before age 60 or within 10 years of menopause.
• •Nonhormonal prescription options include fezolinetant, elinzanetant, and certain antidepressants.
• •Non-drug treatments supported by evidence include cognitive behavioral therapy, mindfulness, exercise, clinical hypnosis, and acupuncture.
• •More than half of women in menopause report vasomotor issues such as hot flashes and night sweats, while up to two-thirds report sleep disruption.