Asia-Pacific Menopause Federation Consensus Statement on the Management of Menopause 2024

Abstract

Objectives: This study aimed to achieve expert consensus on menopause management in the Asia-Pacific region, taking into account patient diversity, the latest evidence, and current treatment options.

Methods: A focused literature search was performed to identify clinical practice statements on menopause management. Menopause experts were nominated by members of the Asia-Pacific Menopause Federation (APMF) society. A modified Delphi methodology, involving iterative rounds of anonymous surveys, was employed until consensus was reached for each statement. Consensus was defined as ≥ 70% of experts voting 'agree' or 'strongly agree' for a given clinical practice statement.

Results: A total of 39 participants from 14 different APMF member societies were involved. Eighty-five clinical practice statements reached a consensus. Based on the clinical practice statements, an algorithm was created as a tool to guide clinicians on menopause management. APMF experts agreed that, in addition to vasomotor symptoms, Asian women experiencing somatic or psychological symptoms may also benefit from treatment with menopausal hormone therapy (MHT). MHT should also be considered for the prevention of osteoporosis in asymptomatic peri- and postmenopausal women.

Conclusions: This APMF consensus statement supersedes the previous one published in 2008. It provides guidance to gynecologists, endocrinologists, family physicians, and other healthcare professionals in delivering optimal care to menopausal women in the ethnically and culturally diverse Asia-Pacific region.

Keywords: Asia-Pacific; Menopausal hormone therapy; Menopause; Osteoporosis; Perimenopause.

Fig. 1. Flow diagram of the delphi process. n: number of experts.

Fig. 2. Algorithm for the management of perimenopausal and menopausal women. MHT: menopausal hormone therapy, SSRI: selective serotonin reuptake inhibitor, SNRI: serotonin-norepinephrine reuptake inhibitor, NK3R: neurokinin 3 receptor, DHEA: dehydroepiandrosterone, HSDD: hypoactive sexual desire disorder. ^aConsider transdermal oestrogen in women with high-risk of venous thromboembolism or a body mass index ≥ 30 kg/m²; ^bNewer therapies that may not be available in some countries; ^cNot in the consensus but mentioned in the International Menopausal Society White Paper [9].