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April/May 2015 (vol. 11/6)
This systematic review of 283 studies on menopause therapies finds high-strength evidence that oestrogen is the most effective treatment both for relieving vasomotor symptoms (eg ‘hot flushes’) and improving quality of life (QoL). There is high-strength evidence that selective serotonin reuptake inhibitors (SSRIs) and serotonin–norepinephrine reuptake inhibitors (SNRIs) also improve vasomotor symptoms and QoL (though to a lesser degree than oestrogen). There is low- to moderate-strength evidence that other non-hormonal treatments (gabapentin, isoflavones, black cohosh) improve vasomotor symptoms. SSRIs/SNRIs and oestrogen are effective in reducing depressive and anxiety symptoms of menopause (high-quality evidence). There is moderate- to high-quality evidence that oestrogen therapy can result in long-term adverse consequences (eg bladder disease and thromboembolic events) as well as benefits (eg reduced risk of osteoporotic fractures). There is low-quality or insufficient evidence on the long-term consequences of non-hormonal therapies.
Occupational Health at Work April/May 2015 (vol. 11/6) pp47