Abstract：
The aim of these recommendations is to set forth an individualized approach to the management of early postmenopausal women (i.e., within the first 10 years after natural menopause) covering all aspects of lifestyle and therapeutic management, with or without menopause hormone therapy (MHT).
Literature review and consensus of French expert opinion. Recommendations were graded according to the HAS methodology and levels of evidence derived from the international literature, except when there was no good-quality evidence.
The beginning of menopause is an ideal time for each woman to evaluate her health status by assessing her bone, cardiovascular, and cancer-related risk factors that may be amplified by postmenopausal estrogen deficiency and by reviewing her lifestyle habits. Improving lifestyle, including nutrition and physical activity, and avoiding risk factors (notably smoking), should be recommended to all women. MHT remains the most effective treatment for vasomotor symptoms but it could be also recommended as first-line treatment for the prevention of osteoporosis in early postmenopausal women at low to moderate risk for fracture. The risks of MHT differ depending on its type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. There is reasonable evidence that using transdermal estradiol in association with micronized progesterone or dydrogesterone may limit both the venous thromboembolic risk associated with oral estrogens and the risk of breast cancer associated with synthetic progestins. Treatment should be individualized to each woman, by using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of its benefit-risk balance. For bothersome genitourinary syndrome of menopause (GSM) symptoms, vaginal treatment with lubricants and moisturizers is recommended as first-line treatment together with low-dose vaginal estrogen therapy, depending on the clinical course. No recommendation of an optimal duration of MHT can be made, but it must take into consideration the initial indication for MHT as well as each woman\'s benefit-risk balance. Management of gynecological side-effects of MHT is also examined. These recommendations are endorsed by the Groupe d\'Etude sur la Ménopause et le Vieillissement hormonal (GEMVI) and the Collège National des Gynécologues-Obstétriciens Français (CNGOF).
Literature review and consensus of French expert opinion. Recommendations were graded according to the HAS methodology and levels of evidence derived from the international literature, except when there was no good-quality evidence.
The beginning of menopause is an ideal time for each woman to evaluate her health status by assessing her bone, cardiovascular, and cancer-related risk factors that may be amplified by postmenopausal estrogen deficiency and by reviewing her lifestyle habits. Improving lifestyle, including nutrition and physical activity, and avoiding risk factors (notably smoking), should be recommended to all women. MHT remains the most effective treatment for vasomotor symptoms but it could be also recommended as first-line treatment for the prevention of osteoporosis in early postmenopausal women at low to moderate risk for fracture. The risks of MHT differ depending on its type, dose, duration of use, route of administration, timing of initiation, and whether a progestogen is used. There is reasonable evidence that using transdermal estradiol in association with micronized progesterone or dydrogesterone may limit both the venous thromboembolic risk associated with oral estrogens and the risk of breast cancer associated with synthetic progestins. Treatment should be individualized to each woman, by using the best available evidence to maximize benefits and minimize risks, with periodic reevaluation of its benefit-risk balance. For bothersome genitourinary syndrome of menopause (GSM) symptoms, vaginal treatment with lubricants and moisturizers is recommended as first-line treatment together with low-dose vaginal estrogen therapy, depending on the clinical course. No recommendation of an optimal duration of MHT can be made, but it must take into consideration the initial indication for MHT as well as each woman\'s benefit-risk balance. Management of gynecological side-effects of MHT is also examined. These recommendations are endorsed by the Groupe d\'Etude sur la Ménopause et le Vieillissement hormonal (GEMVI) and the Collège National des Gynécologues-Obstétriciens Français (CNGOF).
摘要：
这些建议的目的是提出一种个性化的方法来管理早期绝经后妇女（即，在自然绝经后的头10年内）涵盖了生活方式和治疗管理的各个方面，有或没有更年期激素治疗（MHT）。
文献综述和法国专家意见的共识。建议根据HAS方法和来自国际文献的证据水平进行分级，除非没有高质量的证据.
更年期的开始是每个女性通过评估骨骼来评估健康状况的理想时间，心血管,和癌症相关的危险因素，这些危险因素可能因绝经后雌激素缺乏和审查她的生活习惯而被放大。改善生活方式，包括营养和体力活动，避免危险因素（尤其是吸烟），应该推荐给所有女性。MHT仍然是血管舒缩症状的最有效治疗方法，但也可以推荐作为预防低至中度骨折风险的绝经后早期妇女骨质疏松症的一线治疗方法。MHT的风险因其类型而异，剂量,使用期限,给药途径,启动时间，以及是否使用孕激素。有合理的证据表明，经皮雌二醇与微粉化孕酮或地屈孕酮联合使用可能会限制与口服雌激素相关的静脉血栓栓塞风险和与合成孕激素相关的乳腺癌风险。治疗应针对每个女性个性化，通过使用现有的最佳证据来最大化收益和最小化风险，定期重新评估其利益-风险平衡。对于令人烦恼的更年期泌尿生殖系统综合征（GSM）症状，使用润滑剂和保湿剂的阴道治疗被推荐为一线治疗，以及低剂量的阴道雌激素治疗，取决于临床过程。无法推荐MHT的最佳持续时间，但它必须考虑到MHT的初始适应症以及每个女性的获益-风险平衡。还检查了MHT的妇科副作用的管理。这些建议得到了Ménobausa等观察激素小组（GEMVI）和法国妇科学院（CNGOF）的认可。
文献综述和法国专家意见的共识。建议根据HAS方法和来自国际文献的证据水平进行分级，除非没有高质量的证据.
更年期的开始是每个女性通过评估骨骼来评估健康状况的理想时间，心血管,和癌症相关的危险因素，这些危险因素可能因绝经后雌激素缺乏和审查她的生活习惯而被放大。改善生活方式，包括营养和体力活动，避免危险因素（尤其是吸烟），应该推荐给所有女性。MHT仍然是血管舒缩症状的最有效治疗方法，但也可以推荐作为预防低至中度骨折风险的绝经后早期妇女骨质疏松症的一线治疗方法。MHT的风险因其类型而异，剂量,使用期限,给药途径,启动时间，以及是否使用孕激素。有合理的证据表明，经皮雌二醇与微粉化孕酮或地屈孕酮联合使用可能会限制与口服雌激素相关的静脉血栓栓塞风险和与合成孕激素相关的乳腺癌风险。治疗应针对每个女性个性化，通过使用现有的最佳证据来最大化收益和最小化风险，定期重新评估其利益-风险平衡。对于令人烦恼的更年期泌尿生殖系统综合征（GSM）症状，使用润滑剂和保湿剂的阴道治疗被推荐为一线治疗，以及低剂量的阴道雌激素治疗，取决于临床过程。无法推荐MHT的最佳持续时间，但它必须考虑到MHT的初始适应症以及每个女性的获益-风险平衡。还检查了MHT的妇科副作用的管理。这些建议得到了Ménobausa等观察激素小组（GEMVI）和法国妇科学院（CNGOF）的认可。
