2024 NICE Menopause Guideline

The National Institute for Health and Care Excellence (NICE) has published an updated guideline on the diagnosis and management of menopause.

What are the NICE guidelines?

NICE is the organisation responsible for setting out care and services suitable for most people. Its guidelines provide evidence-based recommendations for health and care in England, helping health and social care professionals prevent ill health.

The NICE guideline: Menopause – Diagnosis and Management was first published in 2015 and is accessible to clinicians and the public.

What are the key recommendation changes?

In reviewing the guideline, NICE has evaluated the evidence on:

  • The effects of HRT on overall health outcomes for women, trans men and non-binary people registered female at birth who are experiencing menopause or early menopause.
  • Interventions to manage genitourinary symptoms associated with menopause.
  • Evidence supporting cognitive behavioural therapy to manage symptoms associated with menopause, emphasising it as an option alongside HRT, or for those who cannot or choose not to take it.

The recommendations reinforce that people have the right to be involved in discussions and make informed decisions about their care.  The Menopause Charity works to help everyone understand the changes experienced during menopause, to empowering those experiencing symptoms to make informed choices about lifestyle changes and treatment options.  Learn more about getting the most from an appointment with your healthcare professional.

Hormone Replacement Therapy (HRT)

The guideline lays out clearly the risks and benefits of taking HRT that can be used to help people when they are discussing with their clinician whether to start HRT. Detailed tables lay out the evidence for effects on cardiovascular disease, stroke and dementia risks as well as cancers of the breast, ovary and womb.

The guideline highlights that, while it is important that people know about the risks associated with HRT, it is also important they are made aware it is unlikely to increase or decrease their overall life expectancy.

For more evidence shaping long-term health outcomes for women, see our comprehensive report.

Cognitive Behavioural Therapy (CBT)

Although CBT has previously been recommended to help with the treatment of anxiety and depression in menopausal women, the updated guideline highlights new evidence.  This evidence shows that CBT can also reduce the frequency and severity of hot flushes and night sweats.  Additionally, it may improve sleep issues related to menopause, such as how long it takes to fall asleep and how long before waking.

CBT can be effective alongside HRT or as an evidence-based alternative for those who cannot or choose not to take it.

Learn more about CBT from Cognitive Behavioural Hypnotherapist Louise Philips.

Genitourinary symptoms

The updated guideline also includes new recommendations on the management of genitourinary symptoms such as dryness, painful sex and vaginal discomfort or irritation. A choice of vaginal oestrogen such as cream, gel, tablet, pessary or ring should be offered to women, trans men and non-binary people registered female at birth, including those on systemic HRT, and treatment should be continued for as long as it’s needed to relieve symptoms.

How can I use the NICE guideline as a patient?

NICE guidelines recommend care for individuals with specific clinical conditions or in particular circumstances within the NHS. Patients can use these guidelines to:

  • Receive care  based on the best available clinical evidence.
  • Better understand the impact of menopause and make informed choices about their treatment.

 Discover the information for the patients provided by NICE.

For healthcare professionals

As a healthcare professional, we know that you want to provide excellent menopause care.  The NICE guideline Menopause: diagnosis and management is available to help you deliver high-quality care to the regulatory standards.  They can also help with decisions like prescribing medicines and recommending treatments.

The NICE guideline on the diagnosis and management of menopause, demonstrates the complexity of menopause care.  As a healthcare professional and see patients who may be experiencing menopausal symptoms, check out our resources that can help support the vital work you do.

We want you to feel skilled in the area of menopause and have the resources you need to provide excellent menopause care.  Sign up to our dedicated newsletter to receive more information, tips and advice to help maintain your knowledge and instil greater confidence.

The Need for Further Research in Women’s Health and Menopause

The UK has the largest female health gap among G20 countries and ranks 12th globally, underscoring the urgent need for greater focus and funding in women’s health. The updated guideline further highlights that robust research is needed in many areas of menopause treatment, such as the effects of different types of HRT and the long-term benefits of HRT.

Addressing these knowledge gaps will only be possible if women’s health is prioritised and adequately funded. The guideline consolidates current evidence and calls for more research in key areas of menopause care, recognising its significant impact on global health and wellbeing.