Menopause Association Position Statement: Hormone Therapy in Menopause Care

The Menopause Association affirms that hormone therapy—when prescribed appropriately and individualized to each woman’s needs—can be a safe, effective, and life-enhancing treatment for menopause-related symptoms and long-term health optimization.

We recognize the following guiding principles in our clinical stance:

Evidence-Informed, Patient-Centered Care

We support an integrative model of care that balances scientific evidence, clinical expertise, and patient values. Menopausal hormone therapy should be guided by:

Comprehensive assessment of symptoms, risk factors, and quality of life
Education that empowers patients to make informed decisions
A shared decision-making process between patient and provider

Inclusion of Both FDA-Approved and Compounded Bioidentical Hormones

We advocate for the thoughtful use of both:

FDA-approved hormone therapies, including estradiol, progesterone, and transdermal preparations, and
Compounded bioidentical hormone therapy (cBHT), when individualized dosing, alternative delivery routes, or combination therapies are medically indicated and monitored for safety.

Compounded hormones should be prepared by qualified, accredited compounding pharmacies and dispensed in response to a documented clinical need when no commercially available option is suitable.

Functional and Integrative Approaches

We promote a root-cause, systems-based perspective that addresses hormone imbalance in the context of:

Lifestyle factors (nutrition, sleep, stress, and exercise)
Environmental exposures and detoxification
Gut, thyroid, adrenal, and metabolic health
This broader framework reflects the complexity of midlife transition and provides a foundation for long-term well-being—not just symptom suppression.

Individualized Treatment Over Protocols

Hormone therapy is not one-size-fits-all. We support:

Testing (serum, salivary, or urine) when appropriate for baseline and monitoring based on each type of testing benefits and limitations
Personalized dosing based on symptoms, labs, and clinical response
Reassessment of treatment goals over time

Safety, Monitoring, and Advocacy

We emphasize the importance of:

Informed consent and ongoing monitoring
Risk mitigation strategies (e.g., transdermal routes, use of progesterone with estrogen in women with a uterus)
Protecting access to compounded therapies for patients with specific needs

We also support increased funding for menopause research, clinical education, and broader access to safe, effective treatment options.

Summary

The Menopause Association envisions a future where midlife care is personalized, science-informed, and compassionate. We advocate for a menopause model that integrates conventional and functional medicine, offers both FDA-approved and compounded therapies, and places women at the center of every clinical decision.