Guidance

Recommendations for research

Recommendations for research

The guideline committee has made the following recommendations for research.

Key recommendations for research

1 Impact of HRT on health outcomes in early menopause

What is the effect of either taking or not taking hormone replacement therapy (HRT) on health outcomes for people experiencing early menopause (aged 40 to 44)? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on effects of HRT use in early menopause on specific health outcomes.

Full details of the evidence and the committee's discussion are in evidence review I: early menopause.

2 Type of progestogen in HRT and breast cancer or cardiovascular disease

Do different types of progestogen (for example, micronised progesterone) alter the risks of breast cancer or cardiovascular disease? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on effect of combined HRT on specific health outcomes in people aged 45 or over.

Full details of the evidence and the committee's discussion are in:

3 Mode of administration of HRT

Combined HRT

Do different modes of administration of combined HRT alter the risks of breast cancer, coronary heart disease or dementia? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on effect of combined HRT on specific health outcomes in people aged 45 or over.

Full details of the evidence and the committee's discussion are in:

Oestrogen-only HRT

Do different modes of administration of oestrogen-only HRT alter the risks of breast cancer, coronary heart disease or dementia? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on effect of oestrogen-only HRT on specific health outcomes in people aged 45 or over.

Full details of the evidence and the committee's discussion are in:

4 Safety of vaginal oestrogen use for longer than 12 months

What is the safety of vaginal oestrogen use for longer than 12 months? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on genitourinary symptoms associated with menopause in people with no personal history of breast cancer.

Full details of the evidence and the committee's discussion are in evidence review B1: managing genitourinary symptoms (network meta-analyses).

5 Safety of vaginal oestrogen in terms of breast cancer recurrence

For people with a personal history of breast cancer, or at high familial or genetic risk of breast cancer, does vaginal oestrogen for genitourinary symptoms associated with menopause increase the risk of recurrence or incidence of breast cancer? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on genitourinary symptoms associated with menopause in people with a personal history of breast cancer.

Full details of the evidence and the committee's discussion are in in evidence review B2: managing genitourinary symptoms (breast cancer recurrence).

6 Impact of timing of HRT for menopause-associated symptoms on risk of coronary heart disease

Combined HRT

Does the person's age at menopause or the time between the person's menopause and their first use of HRT affect the long-term risk of coronary heart disease in people who take or have taken combined HRT? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on effect of combined HRT on specific health outcomes in people aged 45 or over.

Full details of the evidence and the committee's discussion are in evidence review C: cardiovascular disease and stroke.

Oestrogen-only HRT

Does the person's age at menopause or the time between the person's menopause and their first use of HRT affect the long-term risk of coronary heart disease in people who take or have taken oestrogen-only HRT? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on effect of oestrogen-only HRT on specific health outcomes in people aged 45 or over.

Full details of the evidence and the committee's discussion are in evidence review C: cardiovascular disease and stroke.

7 Vaginal laser treatment for genitourinary symptoms associated with menopause

What is the safety and efficacy of vaginal laser treatment for genitourinary symptoms associated with menopause? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on vaginal laser treatment.

Full details of the evidence and the committee's discussion are in evidence review B1: managing genitourinary symptoms (network meta-analyses).

8 Impact of HRT on health outcomes for trans men and non-binary people registered female at birth (who are not taking gender-affirming hormone therapy at the time of taking HRT or in the follow-up period)

What is the impact of HRT on health outcomes for trans men and non-binary people registered female at birth (who are not taking gender-affirming hormone therapy at the time of taking HRT or in the follow-up period) in relation to:

  • cardiovascular disease

  • stroke

  • breast, endometrial and ovarian cancer

  • dementia

  • all-cause mortality? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on managing menopause in people who have taken gender-affirming hormone therapy in the past.

Full details of the evidence and the committee's discussion are in evidence review C: cardiovascular disease and stroke.

9 Impact of HRT on health outcomes for people from ethnic minority backgrounds

What is the impact of HRT on health outcomes for people from ethnic minority backgrounds in relation to:

  • cardiovascular disease

  • stroke

  • breast, endometrial and ovarian cancer

  • dementia

  • all-cause mortality? [2024]

For a short explanation of why the committee made this recommendation for research, see the rationale section on effects of combined HRT on specific health outcomes in people aged 45 or over.

Full details of the evidence and the committee's discussion are in evidence review C: cardiovascular disease and stroke.

Other recommendations for research

10 People with a personal history of breast cancer

What is the safety and effectiveness of alternatives to systemic HRT as treatments for menopause-associated symptoms in people who have had breast cancer? [2015]

11 Effects of HRT on dementia risk

What are the effects of HRT use on the risk of dementia? [2015, amended 2024]

12 Premature ovarian insufficiency

What are the main clinical manifestations of premature ovarian insufficiency and the short- and long-term impact of the most common therapeutic interventions? [2015]

13 Breast cancer and venous thromboembolism

What is the impact of oestradiol in combination with the levonorgestrel-releasing intra-uterine system (LNG-IUS) on the risk of breast cancer and venous thromboembolism (VTE)? [2015]

14 Breast cancer recurrence

What is the impact of systemic HRT use in people with a previous diagnosis of breast cancer on the risk of breast cancer recurrence, mortality or the aggressiveness of the tumour? [2015]