After 10 years of debate regarding the risks and benefits of hormone therapy, 15 medical organizations have come together to issue a statement of agreement regarding the benefits of hormone therapy for symptomatic menopausal women.

The new joint statement, prepared by the North American Menopause Society (NAMS), the American Society for Reproductive Medicine (ASRM), and the Endocrine Society, concludes that hormone therapy still is an acceptable treatment for menopausal symptoms. This statement has been endorsed by 12 other leading organizations in women's health.

The statement comes nearly 10 years to the day after the Women's Health Initiative, on July 9, 2002, published its assessment of hormone therapy for the prevention of chronic disease and concluded that risks exceeded benefits.

The purpose of the new statement, the organizations say, is to tell women and their providers that hormone therapy is acceptable and relatively safe for healthy, symptomatic, recently postmenopausal women. During the last 10 years, there has been an abandonment of hormone therapy in some settings accompanied by reluctance to treat women who would benefit from relief of their symptoms, they say. As a result, some women have sought unproven alternative therapies.

"We want to emphasize the difference between taking hormone therapy short term for treatment of menopausal symptoms versus taking hormone therapy for prevention of chronic diseases. Many women can safely take hormone therapy for relief of menopausal symptoms when they work closely with their provider to assess their personal risks and benefits," says Dr. Margery Gass, executive director of NAMS. "Women and clinicians have been frustrated by the many conflicting recommendations over the past 10 years. This statement should be reassuring to all."

Dr. Roger Lobo, past president of the American Society for Reproductive Medicine, adds, "Physicians can help patients determine, based on their own particular characteristics and history, whether or not they are good candidates for hormone therapy and what type of HT will provide them the greatest relief at the lowest risk. A decade of research and analysis has shown us that the generalized conclusions of the WHI do not apply to younger women at the beginning of the menopausal transition."

Of the safety and effectiveness of hormone therapy, one commonly heard lament is that even the experts don't agree. This newly released statement was prepared to address that misperception, participating organizations say, by presenting evidence-based key concepts about hormone therapy to assist women and their clinicians in making informed decisions about use of hormone therapy when appropriate.

There are a number of points of agreement among the groups:

•Hormone therapy is an acceptable option for the relatively young (up to age 59 or within 10 years of menopause) and healthy women who are bothered by moderate to severe menopausal symptoms. Individualization is key in the decision to use hormone therapy.

•If women have only vaginal dryness or discomfort with intercourse, the preferred treatments are low doses of vaginal estrogen.

•Women who still have a uterus need to take a progestogen (progesterone or a similar product) along with the estrogen to prevent cancer of the uterus. Women who have had their uterus removed can take estrogen alone.

•Both estrogen therapy and estrogen with progestogen therapy increase the risk of blood clots in the legs and lungs, similar to birth control pills, patches, and rings. Although the risks of blood clots and stroke increase with either type of hormone therapy, the risk is rare in women ages 50 to 59.

•An increased risk in breast cancer is seen with five or more years of continuous estrogen with progestogen therapy, possibly earlier. The risk decreases after hormone therapy is stopped.

The statement is being published in the journals of the North American Menopause Society, the American Society for Reproductive Medicine, and a number of others.