Criteria for estrogen supplementation during menopause include the presence of menopause-related symptoms, atrophy of the genitourinary tract, low bone mass and osteoporosis.
1. Presence of menopause-related symptoms: Menopause-related symptoms include hot flashes, night sweats, sleep disturbances, fatigue, and mood disorders such as agitation, irritability, anxiety, nervousness, or depressed mood.
2. Genitourinary tract atrophy: conditions associated with genitourinary tract atrophy, such as vaginal dryness, pain, difficulty in urination, pain during sexual intercourse, recurrent vaginitis, recurrent urinary tract infections, nocturnal polyuria, urinary frequency, and urgency.
3. Low bone mass and osteoporosis: This includes having risk factors for osteoporosis (e.g., low bone mass) as well as postmenopausal osteoporosis.
When pregnancy is known or suspected, unexplained vaginal bleeding, known or suspected breast cancer, having a sex hormone-dependent malignancy, active venous or arterial thromboembolic disease in the last 6 months, and hepatic or renal impairment are contraindications to estrogen supplementation during menopause.
Estrogen supplementation during menopause requires a full assessment of the above symptoms by a physician, followed by the selection of an individualized supplementation regimen, not unauthorized medication supplementation.