There's new guidance on menopause symptoms like hot flashes. What women need to know

WASHINGTON, Nov 1, (AP): For the first time in a dozen years, a leading OB-GYN group has updated its guidance on managing hot flashes, night sweats, sleep changes and other disruptive symptoms that often come with menopause. Doctors stressed the importance of hormone therapies, which many women are considering again after the removal of federal safety warnings.

On Friday, federal officials said the Food and Drug Administration has been taking steps to ensure there's an adequate supply. Doctors also described various nonhormonal options in the new advice released this month by the American College of Obstetricians & Gynecologists, or ACOG. "We would love our patients to go to their OB-GYNs regarding questions about menopause and really advocate for getting the treatment that they need,” said Dr. Camille Clare, the group’s president.

Menopause occurs when a woman has gone 12 consecutive months without a menstrual period. In the U.S., it usually happens around age 50. The time leading up to it is called perimenopause, during which the body’s production of the hormones estrogen and progesterone declines sharply. Problems commonly arise. More than half of women in menopause report having "vasomotor” issues such as hot flashes and night sweats, said ACOG.

As many as two-thirds report menopause-related sleep disruption. And more than a third of perimenopausal and postmenopausal women worldwide report depressive symptoms. In the past, doctors said, many women quietly suffered. There's growing consensus that "these symptoms should be treated,” said Dr. JoAnn Manson, a professor of medicine at Harvard Medical School.

"This should help to empower women to discuss their symptoms with their healthcare provider.” Manson said ACOG’s new guidelines are similar to those put out by other medical organizations. "Moderate to severe or bothersome menopausal symptoms should be treated with hormone therapy as the first line of treatment,” she said. While it's not appropriate for all women, she added, it’s a good option for many.

But some have been wary. In 2002, a landmark study in women taking a pill-based combination of estrogen and progestin was stopped early because of links to breast cancer, blood clots and other serious issues. Concerns lingered even though later studies showed the benefits of today’s hormone therapies outweigh the risks for many women.

For more than 22 years, all hormone-based menopause treatments carried a government warning, which Manson said discouraged patients and doctors from using them. But last year, the FDA announced it would remove the boxed warning from more than 20 pills, patches and creams containing the hormones estrogen and progestin. On Friday, the FDA approved updated labeling for three additional estrogen-based patches.

Removing the boxed warning has helped revive interest in and demand for the treatments. Since the FDA labeling change, some women have reported difficulty obtaining estrogen patches in certain doses and formulations. FDA officials said Friday that despite such reports, they are unaware of "an imminent risk of a nationwide shortage.”

Officials also noted that drug manufacturers have doubled their output of the products over the last year by adding extra manufacturing shifts and production capacity. Dr. Stephanie Faubion, medical director at The Menopause Society, said she’s glad to see ACOG’s guidelines stress the importance of these treatments. "It’s undisputed that hormone therapy is the first line and most effective therapy for hot flashes,” she said.