Pre-HT Assessment Tests for Menopausal Hormone Therapy
Menopausal hormone therapy (MHT) decisions should be based on an assessment of baseline cardiovascular disease risk and on age-appropriate cancer screening status. [1]
Routine hormone-level testing is not recommended for initiating MHT for menopausal symptoms. [2]
Baseline Clinical Tests
- Blood pressure measurement is recommended as part of the baseline evaluation for MHT risk assessment. [3]
- Body weight and body mass index assessment are recommended as part of the baseline evaluation for health risk assessment. [3]
Baseline Laboratory Tests
- Lipid testing is recommended as part of baseline laboratory evaluation for cardiovascular risk assessment. [3]
- Fasting blood glucose testing is recommended as part of baseline laboratory evaluation for metabolic risk assessment. [3]
- Liver function testing is recommended as part of baseline laboratory evaluation before MHT. [3]
- Kidney function testing is recommended as part of baseline laboratory evaluation before MHT. [3]
- Complete blood count testing is recommended as part of baseline laboratory evaluation before MHT. [3]
Pregnancy Exclusion Testing Before Systemic Estrogen
- For women who are not definitively postmenopausal and who still have uterine bleeding, pregnancy should be addressed before starting systemic MHT. [4]
- Unwanted pregnancy prevention should be considered when initiating hormone therapy prior to final menstrual period. [4]
Cancer Screening–Related Tests
- Breast cancer screening with screening mammography should be ensured based on age-appropriate U.S. preventive screening recommendations. [5]
- Postmenopausal bleeding should be evaluated promptly for endometrial pathology when it occurs during hormone therapy. [4]
Approach to Cervical Cancer Screening
- Cervical cancer screening should be kept up to date according to routine age-based screening recommendations while considering MHT. [3]
Hormone Level Testing
- FSH, estradiol, and other hormone blood tests are not recommended solely to determine whether MHT should be started for menopausal symptom treatment. [2]