Position Statement by Experts of the Polish Menopause and Andropause Society on menopausal hormone therapy with an oral combination drug containing oestradiol 1 mg and progesterone 100 mg

Abstract

Approximately a third of a contemporary woman’s life is spent in the postmenopausal period. In most women, oestrogen deficiency causes symptoms which significantly impair their quality of life, and leads to a number of long-term health effects [1]. The most commonly used, generally recommended and most effective method of relieving the symptoms of menopause, especially vasomotor in nature, is menopausal hormone therapy (MHT) [2, 3]. For nearly twenty years, there has been a heated debate on the benefit-risk ratio of MHT, which was triggered by the publication of results of the Women’s Health Initiative study in 2003 (6). It has now been established that the risk of adverse effects due to combined MHT, especially involving the mammary gland and the cardiovascular system, depends on the type of progestagen and the type and dose of oestrogen [4–7]. Multiple studies with high quality evidence indicate that from the point of view of the safety profile, the most beneficial form of combined MHT is 17-oestradiol with micronised progesterone [3, 8–11]. This assumption laid the foundation for the concept of body-identical hormone replacement therapy which was proposed in 2014 by Nick Panay [12]. In this context, great hopes are being pinned on the first approved oral combination drug for MHT called Bijuva®, containing a low dose of 17-oestradiol and micronised progesterone. Both compounds, which are the active substances of this drug, are molecularly and chemically identical to the endogenous hormones oestradiol and progesterone [13].