NICE sets out further details on menopause guideline update

Source: NICE 27th May 2022

NICE has outlined what aspects of menopause care will be updated in upcoming guidance, including areas where more research is needed.

The ‘scope’ of the menopause guideline, published on Friday 27 May, sets out new areas of evidence which NICE will look at and consider either making new recommendations or updating existing ones. The following areas have been identified for inclusion in the scope:

  • Managing menopausal symptoms.
    • Cognitive behavioural therapy to manage symptoms associated with the menopause.
    • Interventions to manage genitourinary symptoms associated with the menopause.
  • Effects of hormone replacement therapy on overall health outcomes.

The surveillance and scoping process did not identify any substantive new evidence on using testosterone beyond the current recommendations in the NICE guideline for using testosterone for altered sexual function. NICE discussed the need for evidence in this area with the National Institute for Health and Care Research (NIHR) who have agreed to scope new research.

Dr Gail Allsopp, NICE interim chief medical officer said:

“We recognise the profound impact, ​both physically and psychologically that menopause can have and ​the need for updated guidance. ​We are working at pace on this guideline update to ​ensure ​that its impact ​can be realised as soon as possible.

“We work closely with our stakeholders at the interface of health and care, and after highlighting the gap in the evidence for the use of testosterone, I am delighted that our partners at NIHR have agreed to scope further research into whether testosterone helps to manage menopausal symptoms beyond altered sexual function.”

Minster for Women’s Health Maria Caulfield said:

“Most women will experience menopausal symptoms – some of these can be quite severe and have a significant impact on their everyday activities.

“It’s crucial these can be managed effectively to enable women to continue living their lives and this step forward will ensure healthcare professionals continue to have access to the most up to date evidence and recommendations on menopause care.

“Women’s health is a priority for this government, and we will set out our plans in the first ever government-led Women’s Health Strategy to level up women’s health.”

Professor Lucy Chappell, Chief Executive Officer for the National Institute for Health and Care Research said:

“We welcome this work by NICE to evaluate new evidence that relates to management of the menopause, and the opportunity to address gaps in the evidence base through timely research. We know that this topic is of high importance to many women and healthcare professionals, and this update should provide high-quality recommendations on best practice, not just on menopausal symptoms but also on wider health outcomes.”

While we have identified a need for further research into testosterone, there are a number of areas of new evidence identified that could affect existing menopause recommendations and these will now be looked at by an independent committee of experts.

The new evidence looked at in the guideline update will cover women, non-binary and trans people with menopause aged 40 and older, this will include perimenopause and postmenopause. No new evidence was identified about people with premature ovarian insufficiency, so the existing recommendations will remain in the updated guideline. It will also look at inequalities relating to protected characteristics or other characteristics that might impact people’s access to care, their experience of care and their menopause process, such as age, disability, ethnicity, socioeconomic status, and gender identity.

To view the scope please visit Menopause: diagnosis and management update page

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