In this episode of CME On the Go, our hosts revisit menopause through a case of a 51-year-old with seven months of amenorrhea, vasomotor and cognitive symptoms, and osteopenia-range DEXA findings, highlighting that she is perimenopausal. They note the limited role of FSH/LH testing and the need to rule out other causes. The episode focuses on systemic hormone therapy, recommending 17β-estradiol with progesterone for patients with an intact uterus, favoring transdermal routes for lower risk, gradual dose titration, shared decision making, and supportive lifestyle measures. Learning Objectives Learn how to select proper dosing and route of administration for estrogen replacement therapy including initiation, adjustments through monitoring, and discontinuation. Discuss non-medicinal strategies for healthy aging in the menopausal woman including issues around sleep management, general cardiovascular fitness, and dementia. The AAFP has reviewed Hot Takes and Flashbacks of Menopause and deemed it acceptable for up to 0.50 Enduring Materials, Self-Study AAFP Prescribed credits. Term of Approval is from 03/09/2026 to 6/4/2027. Physicians should claim only the credit commensurate with the extent of their participation in the activity. The AAFP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians. The American Academy of Family Physicians designates this Enduring Materials for a maximum of 0.50 AMA PRA Category 1 credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity. CME activities approved for AAFP credit are recognized by the AOA as equivalent to AOA Category 2 credit. After listening to the podcast episode, claim 0.5 AAFP credit by following the provided link. https://www.aafp.org/assessment/take/19730/e References and Resources Menopause and Perimenopause Livestream: https://www.aafp.org/cme/all/womens/menopause-perimenopause-hrt.html Menopause Management: When Hormone Therapy Is Appropriate: https://www.aafp.org/pubs/afp/issues/2026/0200/editorials-menopause-management.html Hormone Therapy for the Primary Prevention of Chronic Conditions in Postmenopausal Women: https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2017.16952?utm_source=openevidence&utm_medium=referral Blog Article: More people than ever are interested in menopause. Family physicians should be, too: https://www.aafp.org/news/blogs/aafp-voices/menopause-perimenopause-education.html ACOG President Says Label Change on Estrogen Will Increase Access to Hormone Therapy: https://www.acog.org/news/news-releases/2025/11/acog-president-says-label-change-on-estrogen-will-increase-access-to-hormone-therapy https://www.webmd.com/menopause/which-type-of-estrogen-hormone-therapy-is-right-for-you https://www.ncbi.nlm.nih.gov/books/NBK493191/ https://pmc.ncbi.nlm.nih.gov/articles/PMC12463494/#:~:text=Estrogen%2C%20with%20or%20without%20progestogen,genitourinary%20symptoms%20after%20medication%20termination. The NAMS 2017 Hormone Therapy Position Statement Advisory Panel. The 2017 hormone therapy position statement of The North American Menopause Society. Menopause. 2017;24(7):728-753. doi:10.1097/GME.0000000000000921 . Yet, the latest update from WHI showed that HT with CEE + MPA or with CEE alone was not associated with risk of all-cause, cardiovascular or cancer mortality during a cumulative follow-up of 18 years (Manson et al., 2017 Manson JE, Aragaki AK, Rossouw JE, Anderson GL, Prentice RL, LaCroix AZ, Chlebowski RT, Howard BV, Thomson CA, Margolis KLet al. Menopausal hormone therapy and long-term all-cause and cause-specific mortality: the Women's Health Initiative randomized trials. JAMA 2017;318:927–938. Clare Oliver-Williams, Marija Glisic, Sara Shahzad, Elizabeth Brown, Cristina Pellegrino Baena, Mahmuda Chadni, Rajiv Chowdhury, Oscar H Franco, Taulant Muka, The route of administration, timing, duration and dose of postmenopausal hormone therapy and cardiovascular outcomes in women: a systematic review, Human Reproduction Update, Volume 25, Issue 2, March-April 2019, Pages 257–271, https://doi.org/10.1093/humupd/dmy039 Disclosure: It is the policy of the AAFP that all individuals in a position to control content disclose any relationships with commercial interests upon nomination/invitation of participation. Disclosure documents are reviewed for potential conflicts of interest and, if identified, conflicts are resolved prior to confirmation of participation. Only those participants who had no conflict of interest or who agreed to an identified resolution process prior to their participation were involved in this CME activity. All individuals in a position to control content for this session have ...
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