The guidelines, announced Thursday, aim to help clinicians navigate a landscape of conflicting information about menopause treatments. They cover vasomotor symptoms (such as hot flushes and night sweats) and genitourinary symptoms (including vaginal dryness and frequent urination), which can significantly affect quality of life during the menopausal transition.
RANZCOG guideline development group chair Catriona Melville said the college wanted to "cut through the noise" and give clinicians a solid evidence base to discuss treatment options with patients.
"If your clinician is not clear about where the evidence lies and what's safe and what isn't safe, and what's recommended and what isn't recommended, then they're not in a position to have that patient-centred discussion about what the available [treatment] options are," Dr Melville said.
The guidelines list possible treatments including menopausal hormone therapy (MHT), acupuncture and hypnosis, with evidence ranked on a scale from very low to high. They clarify when MHT should be preferred over other medicines and provide options for women with a history of breast cancer, such as vaginal oestrogen. RANZCOG recommends that women taking MHT have an annual review with their doctor.
The guidelines do not cover management of bone density, joint pain, libido, depression or anxiety.
Magdalena Simonis, a practising GP and women's health expert from the University of Melbourne not involved in developing the guidelines, said they reinforced the need to treat the whole person. "We should also be looking at lifestyle and other risk factors around the time of the menopause," Dr Simonis said, pointing to cholesterol control, bone density management, cancer screening and chronic condition planning.
Dr Melville noted that while RANZCOG had previously released statements on managing menopausal symptoms, these were its first evidence-based guidelines.